North Carolina Association of Alcoholic Residential Facilities

(NCCARF)
Funding Request 

Applications accepted by August 30th

The NCAARF Organization will accept requests for emergency funding for up to $5,000.00 every year based on the availability of NCAARF’s financial status.  Funding will be given on the basis of financial need and emergency assistance and will not be given for the personal use of individuals. You must be a non-profit organization with a 501-(c)-3 tax-exempt status.

Please provide the following information:

DATE OF APPLICATION: __________________________________________

NAME OF AGENCY, INSTITUTION OR ORGANIZATION: _________________

_______________________________________________________________

ADDRESS: ______________________________________________________

TELEPHONE NUMBER: ___________________________________________

NAME OF CONTACT PERSON: ____________________________________

Position with agency, institution or organization: ___________________________

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PLEASE GIVE REASON FOR REQUEST (Be specific to the need and do not exceed two (2) pages).

AMOUNT REQUESTED: ____________________

HAVE YOU SUBMITTED AN APPLICATION PREVIOUSLY?  YES ___   NO ___

If yes, when? _________________________________

Was your funding request granted?   YES ___   NO ___

If yes, how was the money used?  (Please be specific)

ADDITIONAL INFORMATION NEEDED:  Please attach the following –

ü      Copy of your IRS letter indicating 501-(c)-3 tax-exempt status

ü      Copy of your current budget with a breakout of how the money will be used.  Please be specific as to all revenue sources and expenditures.

ü      Complete list of current Board of Directors & Officers

Deadline for submitting a request is August 30th!

Mail Requests to:
Lloyd Parsons
C/o Grant Request/NCAARF
705 Ward Road
Denton, NC 27239

APPLICANTS WILL BE NOTIFIED OF THE COMMITTEE’S ACTION ON OR BEFORE OCTOBER 31^ST!