Electronic Submission Form

If you would like to determine if your project is eligible prior to submitting your complete application, you may submit a Pre-Application for review.

The proposed project will be reviewed for eligibility under the Foundation’s grant guidelines. You may be contacted for more information or receive a message declining your project as ineligible. If your project is eligible, you will receive an e-mail inviting you to submit a full application with appropriate supporting documentation.

For best results it is recommended that you use Internet Explorer 6 or higher to process this form. If you have difficulty in submitting this form due to your local ISP please print and fax this form to: 305-367-6327.

Date of Submission: (MM-DD-YYYY)
Organization Name:
Tax ID:
This organization is an IRS qualified 501(c)(3) charity:
If your organization is not a 501(c)(3), you may not continue.

Contact Name:
Address cont'd:
Zip Code:
Telephone: ( ) - - (XXX)-XXX-XXXX
Fax: ( ) - - (XXX)-XXX-XXXX
Number of Employees
Total Assets:
Area Served:
Operating Budget:
Amount Requested:
Total Project Budget:
Other Sources of Project Support:

The Project specifically and primarily benefits the population of: Projects in other areas are ineligible.

Project Start Date: (MM-DD-YYYY)
Project End Date: (MM-DD-YYYY)
Project Title:
Target Population:

Mission Statement:
(up to 225 characters)

Briefly describe the project, its goals and the means by which you propose to achieve them:
(up to 1000 characters)

  * Do not submit materials with the "Pre-application".
Please only submit once. After board review and approval you will be sent an electronic invitation to submit a full application.
  * Grant support is provided to non-profit, tax exempt organizations as defined under section  501 (c) (3) of the United States Internal Revenue Service (IRS) Code. The foundation will review proposals submitted by tax exempt organizations that assume legal, fiscal and administrative responsibility for approved grants.