Foundation Grant Request | Nevada Bar Foundation

Organization Name*

Organization Address*

Street Address City State ZIP Code

Primary Contact*

First Last

Email Address*

Phone Number*

Organization Information

Briefly describe your organization's mission and goals (250 words or less).*

Please list your organization's sources of revenue.*

List all sources of revenue and amounts received for each.

What is your organization's IRS designation (Ex: 501(a); 501(c)(3); etc.).*

Funding Request

Total Amount Requested*

Is funding sought for one year or multiple years?*

One Year (One-time request)
Two Years

Please indicate if total amount requested is for one or two years. (Total funding amount remains the same.)

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 diversity, equity, 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 (Please Explain)

Please provide an overview of the program for which the organization seeks funding. Please include the program's goals and objectives and how the funds would support those goals and objectives.*

If requested funding cannot be provided in whole, do other sources of funding exist? Please describe.*

Does your organization have a matching fund program?*

Example: along with an approved grant, 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.

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.*

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

This application represents what percentage of the organization's overall annual budget?*

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*

Please provide a list of the organization’s Board of Directors or leadership, including name, phone number and email address.*

Please provide a copy of your organization's IRS determination letter. If not a tax exempt organization, please attach an explanation of the IRS status.*