Youth Development Application

Please note:

Grants will not be accepted after these dates: January 30 for consideration at the February meeting or July 30 for consideration at the August meeting.
You must complete the entire application before submitting it.
You will be notified of the Board's decision via email.

Organization Name

Amount Requested ($)

Organization Website

Federal ID

Full Name

Position Held

Phone

Address

How did you hear about Life Line Homes?

Briefly describe the Church or Agency which is applying for this grant, explaining your mission and those you serve.

Share with us the problem your grant seeks to address and the solutions you envision with the help of our funds.

Share how you will evaluate whether your project has been successful and how you will report, to us, the use of our funds.

Share how you will continue to fund this project once the startup funds, which we provide, are exhausted.

By checking this box, you agree to the following:

Use the funds provided by Life Line Homes for the purpose described in this application.
Return any unused funds to Life Line Homes.
Provide appropriate public acknowledgment of the grant.
Submit a followpup report/evaluation to Life Line Homes for their permanent file.
Provide pictures and/or testimonials with permission for us to use them in our publicity (printed or web).
Verify that your agency is a 501(c)3.

Signature

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