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Funding Summary Report Request Form
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Funding Summary Report Request Form
Organization Name Organization Website (if available) Primary Contact Name Title / Role Email Address Phone Number City and State where your organization operates
Organization Status Is your organization a registered nonprofit 501(c)(3)? ☐ Yes ☐ No ☐ In the process of applying Year organization was founded
Program Information Program or initiative name Brief description of the program (What does the program do?)
What problem does the program address? Examples: • youth development • community safety • education support • food insecurity
Confirmation Message (After Form Submission) Your request has been received. A representative from IM Enterprise LLC will review your information and contact you 3-5 days regarding your Funding Summary Report.
Submission Notice Once your form is submitted, IM Enterprise LLC will review your information and prepare your Funding Summary Report within 3–7 business days. The report will include: • targeted grant opportunities • recommended funders • funding strategy outline • suggested grant request amounts • program alignment advice
Additional Information Have you received grants before? ☐ Yes ☐ No If yes, please list examples. What makes your program unique or impactful? Is there anything else we should know about your program?
Funding Needs How much funding are you seeking? ☐ $5,000 – $10,000 ☐ $10,000 – $25,000 ☐ $25,000 – $50,000 ☐ $50,000+ How will the funding be used? Examples: • program materials • staffing • equipment • outreach activities
Program Impact Approximately how many people will the program serve annually? What activities will the program include? Examples: • workshops • community events • education programs • safety initiatives • outreach services
Geographic Area Where will this program operate? Examples: Charlotte NC Mecklenburg County Statewide National
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