Signature of Authorized Persons

I hereby endorse this project and submit it to the Coughlin-Saunders Foundation on behalf of the organization named in this application. I have full authority to submit this proposal to the Foundation. Further, my signature certifies that this organization curretnly has tax-exempt status under Internal Revenue code section 501(c)(3) and is classified as "not a private foundation."


Chief Executive Officer


Chief Financial Officer



Checklist of Attachments

  • Copy of 501(c)(3) letter from the IRS – required for all grant requests

  • A list of the members of the governing board of the organization - required for all grant requests

Required for all requests over $5000

  • Financial Statements

  • Line item budget

  • Plans for future funding

Optional Materials. Please provide no more than three. Statements should not exceed one page of double-spaced text. Brochures may be included in the three optional items (Please handwrite a brief description of items here).


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