Pacific Southwest District – Lutheran Women’s Missionary League

GRANT APPLICATION – FORM TO BE RETURNED

Please place this page on top when returning your application.

A. PROJECT PERSONNEL: Directory of Grant Personnel (Names, Titles and Approvals)

Name of Proposed Grant ____________________________________________________________

Amount Requested _________________________________________________________________

Submitter Name ___________________________________________________________________

Address: __________________________________________________________________________

Phone: ____________________________________ e-mail: ________________________________

 

LWML Member Name (other than submitter): _________________________________________

Address __________________________________________________________________________

Phone Number ____________________________ e-mail: ________________________________

Signature _____________________________________________ Date: _______________________

 

President of LWML Society, Zone or District ____________________________________________

Phone Number ____________________________ e-mail: __________________________________

Signature _____________________________________________ Date: _______________________

 

Pastor of congregation or Pastoral Counselor of the LWML Zone or District

Pastor: ___________________________________ Congregation: _____________________________

Signature ________________________________________________ Date _______________________

 

Grant Administrator ___________________________________________________________________

Address ______________________________________________________________________________

Phone number _____________________________ e-mail: ____________________________________

______________________________________________________________________________________

Signature of Grant Administrator Date

Funds to be sent to: _____________________________________________________________________

Address _______________________________________________________________________________

Phone ____________________________________ e-mail: _____________________________________

Grant Proposals will be accepted for review ONLY when the required signatures above are provided.


B. BASIC FINANCIAL STATEMENT:

1. Identify the amount of funds requested:

2. Specify why funds are currently needed:

 

 

3. Itemize specific (detailed) use of funds.

 

 

4. List total amount and source of additional funds for this project:

 

 

5. Identify planned source and amount of continued funding for maintenance and support of this project after LWML funding ceases:

 

C. BASIC PROJECT PLAN: (Be concise)

1. Project’s Vision/Mission:

 

 

2. Project’s Gospel Outreach plans:

 

 

D. RESOLUTION: (Be concise, & follow the format of the example above)

WHEREAS: (state the project goal and its Biblical basis)

 

 

WHEREAS: (State the need for the project)

 

 

WHEREAS: (State further needs if applicable)

 

 

WHEREAS: (State amount requested and the purpose for which the funds will be used)



THEREFORE BE IT RESOLVED: (State, in summary terms, the specifics of the resolution)

 

 

E. LETTER OF RECOMMENDATION:

1. Provide the names, positions and comments of at least one, and no more than three, people having special knowledge of this project:

 

 

 

2. Attach one letter recommending the PSWD LWML fund this project.

F. SUMMARY STATEMENT:

Summarize your request in 50 words or less for inclusion in the Convention Manual, should your project be on the ballot:

 

 

Submit completed form to Angelina Gomez, 117 S. Maple Ave. Apt. #B, Montebello, CA 90640

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