We at the Kemmons Wilson Family Foundation would like to thank you for your efforts to thoughtfully prepare your grant request. We look forward to learning about the ways in which you and your organization plan to enrich the Memphis area community.

Please complete this form and save as a PDF. To save as a PDF, complete the form in its entirety and click the “Save Request Letter as PDF” button. The form cannot be saved as you go. A new online application format will be available soon. We regret any inconvenience.

Once completed, please print and mail this form with the other requested materials or add it as an attachment and send it by email with the other requested materials. Please either mail or email the Request Letter Packet as a whole. Do not send a portion of it by mail and the other portion by email.
grant summary
Date:
Name of Organization:
Executive Director:
Tax ID Number:
Name of Contact Person
Title:
Address:
Email Address:
Phone Number:
Web Address:
Category of Giving:
Project/Program to be Funded:
Amount of Grant Request:

Specific KWFF Grant History:

Organization's Mission Statement:
Grant Request Summary:
Grant Request Details
 
- List Project Objectives:
- Explanation of need and data to support:
- List major non financial community partners:

Total Cost of Project:

Fund Raising Goal Amount:

- Specific use of requested KWFF funds:
- Percentage of KWFF grant request to total fundraising goal:
- Funds raised to date - include major sources of funding and amounts:
 - Percentage of organizations' board members financially supporting project:
* PLEASE ATTACH A ONE PAGE LIST OF BOARD OF DIRECTORS AND A ONE PAGE SUMMARY OF PROJECT BUDGET BREAKDOWN.
Details
Please complete this form in its entirety using current local organizations' financial information.
Name of Organization:
Contact Name for Financial Information:
Financials audited on an annual basis?:
Date of Current Financials:
Year Total Revenue (A):
  Grants Recieved:
  Endowment Income:
Year Total Expenses(B):
Net Change in Assets (profit/loss) (A-B)



 
Percent of Program EXP to Total EXP:
Percent of Fundraising EXP to
Total EXP:
Percent of Admin EXP to
Total EXP:
   
Total Assets (C):
  Liquid Assets:
  Investments:
  Restricted Assets (Please Explain):
Total Liabilities (D):
  Current Liabilities:
  Third Party Debt:
Net Fund Balance (C-D):
*Please attach current financials and a copy of latest audited financials
*Please direct financial review questions to tcline@kwilson.com
Once this form is completed in its entirety please save as a PDF. You can print out and mail this form with the other requested materials or add it as an attachment and send it by email with the other requested materials. Please either mail or email the Request Letter Packet as a whole. Do not send a portion of it by mail and the other portion by email.