Foundation Grant Request | Nevada Bar Foundation

Organization Name*

Organization Address*

Street Address City State ZIP Code

Primary Contact*

First Last

Email Address*

Phone Number*

Is this the primary contact for the grant request?

Yes
No

Grant Contact

First Last

Grant Contact Email

Grant Contact Phone

Organization Information

Year Organization Incorporated*

Federal Tax ID Number*

Attestation*

Select All
The organization is a 501(c)(3) public charity.
The organization is not a 501(c)(3) private foundation.
The organization is not a 509(a)(3) supporting organization.

In 500 words or less, please describe the purpose of the organization and its overall programs and services.*

This section is intended to provide the Foundation with a high-level overview of the services provided by your organization. The summary should provide information relevant to your grant application goals and objectives.

Organization Budget

Current Year Revenue*

Current Year Expenses*

Next Year Projected Revenue*

Next Year Projected Expenses*

Funding Request

Program Title*

Total Amount Requested*

Will requested funding be used for a new program or existing program?*

New Program
Existing Program

Type of program for which funds are requested. (Check all that apply)*

Provide education to Nevada attorneys on topics such as civility; well-being; and inclusion.
Support law related education programs that promote interest in and understanding of the law.
Support the activities and initiatives of affinity bar associations that serve minority lawyers.
Directly support delivery of legal services to underserved populations.
Provide for the delivery of pro bono legal services.
Other

Note, follow up questions to each checked category will follow.

In 150 words or less, please provide an overview of requested funds will provide education on topics such as civility, well-being, and inclusion..*

In 150 words or less, please provide an overview of requested funds will support law related education programs that promote interest in and understanding of the law.*

In 150 words or less, please provide an overview of requested funds will support the activities and initiatives of affinity bar associations that serve minority lawyers.*

In 150 words or less, please provide an overview of requested funds will support support delivery of legal services to underserved populations.*

In 150 words or less, please provide an overview of requested funds will provide for the delivery of pro bono legal services.*

In 150 words or less, please provide an overview of the "other" intended uses for requested funds.*

In 150 words or less, please explain how you will market the program to your prospective audience.*

Provide any other sources of funding, pledged or in-hand, for the program or activity requested.*

Will this program be able to continue after all NBF funds are expended? Please explain.*

Additional Information

Did your organization receive funding for this program last year?*

Yes, State Bar of Nevada IDEA Grant
Yes, NBF Foundation Grant
Yes, IOLTA Grant
No

Previous year IDEA grant award*

Previous year NBF Foundation grant award*

Previous year IOLTA grant award*

Have all the previous year grant awards been expended?*

Yes
No

What amount remains?*

How do you plan to evaluate the program for which funding is received to ensure grant dollars are being used effectively?*

Does your organization have a matching fund program?*

Example: along with an approved grant of $5,000, a $5,000 incentive grant may be given for the organization successfully raising another $5,000 through a fund-raising initiative or private donation, etc., for a total of $15,000.

Please share any additional information which may assist the Foundation in considering your request.

Agreement for Use of Funds

The undersigned, on behalf of the organization, consents to:*

Select All
Utilize the funds granted to this organization solely for the purpose permitted and outlined in the application.
Agree not to use funds for sponsorship of events or activities.
Agree not to use funds for activities which influence legislation, influence the outcome of any election, or which are used to carry on any voter registration drive.
Agree to repay the Nevada Bar Foundation any amount not used for the purposes of this grant.
Release its application and subsequent reports as property of the Nevada Bar Foundation for use of any or all information presented, whether or not the application is accepted for funding.
Agree that all decisions and determinations regarding the grant or denial of funds as requested by each Applicant is at the sole discretion of the Trustees of the Nevada Bar Foundation.
Appropriate credit or recognition to the Nevada Bar Foundation in any printed or electronic materials and communications describing activities which are wholly or partially funded by grant funds.
Submit an annual report regarding the use of funds, on a form provided by the Nevada Bar Foundation, for each grant year on the anniversary date of initial grant approval.

Signature*

Please type full name

Date*

Addendum

Please upload PDF copies of the following.

Previous Fiscal Year 990 Form

If your organization is not required to file tax returns, please upload an explanation. This may be a short paragraph; PDF format.

A list of the organization’s Board of Directors or leadership, including name, phone number and email address. (PDF)*

A copy of your organization's IRS determination letter. If not a tax exempt organization, please attach an explanation of the IRS status. (PDF)*