JOM Grant Application – Nonprofit Organization Agency Name(Required) Organization Website Address(Required) Street Address City State / Province / Region ZIP / Postal Code Name and contact info of person submitting application First Last Email(Required) Phone(Required)Requested Amount $ (Awards typically range from $1,500-$20,000.)(Required) Project Title (or General Support if the entire organization’s work is aligned with the program area for which you are applying)(Required) Project Summary (Suggested limit: 50 words)(Required)Project Start Date(Required) MM slash DD slash YYYY Project End Date(Required) MM slash DD slash YYYY Total Annual Organization Budget(Required) Total Project Budget(Required) Program Area(Required)Mental HealthHealth ChallengesDrug AbuseEducationNumber of people to be served by the program(Required)Please describe your organization including history, mission, and types of programs/services provided. Also, please note how many people the agency served in the last year. (Suggested limit: 250 words)(Required)Please describe your program including population served, need for the program, proposed activities, how it aligns with the Just One More Foundation’s mission and funding area(s), and timeline (Suggested limit: 500 words)(Required)What are the anticipated outcomes of the program? (Suggested limit: 250 words)(Required)Please describe the qualifications of the key leaders for the organization and the program for which you are applying, and the length of their tenure. (Suggested limit: 250 words)(Required)Required Attachments: IRS Letter of Determination, Project budget detailing all proposed expenditures, and projected sources of funding (if applicable), Audited or similarly certified financial statement, List of board members and their affiliations. Drop files here or Select files Max. file size: 2 GB. HiddenConsent/Agreement(Required) Grantees are required to submit a report at the end of the project. By signing (clicking on this box), you agree to submit a grant report by the Foundation deadline. The report form will be provided to grantees.Consent/Agreement(Required) Grantees are required to submit a report at the end of the project. By signing (clicking on this box), you agree to submit a grant report by the Foundation deadline. The report form will be provided to grantees. CAPTCHA