Eighteen-Eighty (1880) Society Fund Southern University System Foundation Grant ApplicationEntity: *Community OrganizationSouthern University Unit Name of Organization * City State ZIP Code Application Date Telephone * Email Address Names and Titles of Individuals Submitting Request Date Organization was Founded (mm/dd/yyyy) Grant Category ResearchSpecial ProgrammingCapacity Building Amount Requested * Total Organization Annual Budget Program/Project Title Dates of Program/Project Enter exact date (mm/dd/yyyy) or date range Please summarize, in a short paragraph, the purpose of your department or agency and project Briefly explain why your department or agency is requesting this grant, what outcomes you hope to achieve, and how you will spend the funds if a grant is awarded. Other funding sources being solicited for this program/project Amount Requested Amount Received Subject Focus Geographic & Demographic Populations Served BudgetExpenditure Description * Amount * Expenditure Description Amount Expenditure Description Amount Expenditure Description Amount Expenditure Description Amount Expenditure Description Amount Expenditure Description Amount Please attach the followingCopy of your yearly fiscal operating budget Community organizations only Copy of last year's audited financial statement Community organizations only Application SignatureI certify the information provided on this application is true and correct to the best of my knowledge. Signature * Date * Select Option 1Option 2Option 3 URL VerificationDigital Signature *Please complete the application by entering a two-digit, digital signature (e.g. 12)This box is for spam protection - please leave it blank