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Grant Application
Sponsoring Group:
*
Is this group incorporated?:
*
Yes
No
If no, please identify type of organization:
Limited Liability Company (LLC)
Partnership
Joint Venture
Trust
Individual
Provide a copy of your document registering your organization with your government.
Max. file size: 64 MB.
What other organizations have or will support the proposed project financially or with in-kind assistance?
*
Amount Requested
*
Request Information
Purpose of Request:
*
For what purposes will these funds be used: (1) Provide details, sources of funds/uses of funds and/or budget and (2) specific details on each expenditure.
*
How will these requested funds support the conservation, education or hunting advocacy goals of the Dallas Safari Club?:
*
Financial Information
Please submit financial statements using the “browse” button below. Your financials must include the previous year’s INCOME STATEMENT showing income and expenses and a BALANCE SHEET showing your liabilities, assets and equity. There is a 10 mb limit on the file size.
Financial Information - Income Statement: Profit and Loss Statement or Revenues and Expenses for the previous year.
*
Max. file size: 64 MB.
Financial Information - Balance Sheet: A standard company balance sheet has three parts: assets, liabilities and ownership equity.
*
Max. file size: 64 MB.
Is this group a 501(c)(3) corporation?:
*
Yes
No
(U. S. registration only) or an approved non-profit in your country?
If no, what is your non-profit exemption code?
Only answer if you selected No on the 501(c)(3) question above.
EIN/ Tax ID # (if applicable) :
(This number MUST be provided for Federal Tax purposes before funds will be distributed.) ,or non-profit tax number (for Non-US Country).
CONTACT PERSON:
*
MAKE CHECKS PAYABLE TO:
*
PLEASE LIST THE ADDRESS IN WHICH TO SEND THE CHECK
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
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Algeria
American Samoa
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Angola
Anguilla
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Qatar
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Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
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Samoa
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Slovenia
Solomon Islands
Somalia
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South Georgia and the South Sandwich Islands
South Sudan
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Sudan
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Syria Arab Republic
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Tanzania, the United Republic of
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Virgin Islands, U.S.
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Country
Phone
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Wiring Instructions
(Please complete address portion above even if you wish to receive funds through a wire. Only complete the section below if you do NOT wish to receive a check)
Bank Name
IBAN#
Swift Code
Account Number
Name on the Account
ALL QUESTIONS MUST BE ANSWERED IN FULL AND DOCUMENTS PROVIDED FOR YOUR GRANT APPLICATION TO BE CONSIDERED.
Please note that there may be reporting conditions and requirements. For more information, contact Terri Lewis, Operations Manager at terri@biggame.org.
