FCI Game Changer Grant Short Form
RequiredRequired Question(s)
Required

Please enter your contact information below.


First Name:
Last Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
Organization:

Required
Organization website and/or Social Media Page
 

350 characters left.
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Total Organizational/Program Budget
 

50 characters left.
Required
Year Organization/Program Established
 

50 characters left.
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Type of Organization
501c3
501c4
Project sponsored by another 501c3
An initiative undertaken by a group of at least 3 unrelated individuals
Name of Fiscal Sponsor (if applicable)
 

50 characters left.
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Is your request time sensitive? (must be funded in six months or less)
Yes - If so, please indicate timeframe in the comment section below
No
  • Comment:

  • 500 characters left.
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Define the geographic area served by your request
 

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Brief description of request for funding and how it addresses racial and socioeconomic disparities.
 

1000 characters left.