Community Giving Initiative Submission Form

Thank you for your interest in applying for the Poka Lambro Community Giving Initiative! Please complete the following form to submit a nomination for your nonprofit organization. All submissions must meet the eligibility criteria outlined on the program page.

Deadline: All nominations must be received by the 15th of the last month of each quarter: March 15, June 15, Sept. 15 and Dec. 15.

Step 1 of 6

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This field is for validation purposes and should be left unchanged.

Organization Information

Organization Name(Required)

Website(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How We Should Reach You

Primary Contact Name(Required)

First Last

Primary Contact Phone(Required)

Primary Contact Email(Required)

Project Information

Project Name(Required)

Description of Project or Program(Required)

Provide a detailed description of your project or program. Be specific about the objectives, target audience and activities. (Maximum 500 words)

Community Impact(Required)

How will your project impact the community? Please describe the number of people served and the long-term benefits of this program. Include specific examples and data if possible. (Maximum 300 words)

Project Timeline

When will the project begin, and when is it expected to be completed?

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Amount Requested(Required)

Please specify the exact amount of funding requested and a brief justification for this amount.

Location of Project(Required)

Please specify the communities or geographic area where the project will be implemented.

Financial Information

How will this funding contribute to the success of the project?(Required)

Explain why the funding is critical to the success of your project. How will this donation make a difference? (Maximum 250 words)

Have you received any funding from Poka Lambro in the past 2 years?(Required)

Yes

Budget Overview

Please provide a breakdown of the project budget. Include total costs, how the funding will be used, and any matching funds or additional sources of support.(Required)

Supporting Documents

Proof of Nonprofit Status(Required)

Max. file size: 100 MB.

Please upload your IRS 501(c)(3) determination letter.

Organization’s Annual Budget(Required)

Max. file size: 100 MB.

Please upload the most recent annual budget for your organization.

Program Budget(Required)

Max. file size: 100 MB.

Please upload a detailed budget for the specific program/project you are seeking funding for.

Upload Financial Statements(Required)

Drop files here or

Max. file size: 100 MB.

Did you use a grant writer to help with this application?(Required)

Yes

Grant Writer Contact Information(Required)

List other major sources of funding your organization currently receives.

Additional Information

Evaluation & Reporting(Required)

I understand and agree to submit a follow-up report.

If awarded the donation, your organization will need to provide a follow-up report on how the funds were used and the impact of the project. Please confirm your understanding and willingness to submit a report at the completion of the project

Publicity and Media Consent (optional)

I consent to publicity.

By submitting this form, you agree to allow Poka Lambro to use your organization’s name, images and other materials for marketing and promotional purposes, including on our website and social media platforms.

Name of Authorized Person(Required)

Title(Required)

Applicant Electronic Signature(Required)

By typing my full name in this space, I hereby warrant that all information provided is accurate to the best of my knowledge.