Please us this form along with the Budget and Budget Narrative forms to complete your three part grant application for funds from the ARRL Foundation. Complete each section of this form in one page or less. Please avoid attaching videos, DVDs, photos, testimonials or other supporting documents unless requested by the ARRL Foundation.

Section 1.   Organization Overview and Purposes:

Section 2.    Project Summary:

Section 3.    Project Details:
(audience, estimated duration, location, purpose):

Section 4.   Project Impact:
(estimated outcome for organization, for community, for amateur radio)

Section 5.   Other project funding:
(sources, amounts, purposes -- be specific)

Section 6.   Other ARRL Foundation Grants:
(Date/ Project/ Amount/Impact for each)

Section 7.    Leadership:
(Provide name, call sign and contact information for all that apply)

Organization Officers:
President:
Vice President:
Treasurer:
Secretary:

Project leader(s):
(Provide names and call signs and qualification for project leadership)

Grant Application Prepared by:

Date Prepared:

Preparers Signature:

Name:
Call Sign:

Organization President Signature:

Name:
Call Sign

Contact Information:

Mailing Address:
City State Zip Code
Telephone Number:
Email:
Website:

For the ARRL Foundation April 21, 2004