1. Name of Applicant Organization: (Please use full legal name as designated in current articles of incorporation).

_____________________________________________________

Employer Identification Number (EIN): _____________________

2. Street Address / P.O. Box: __________________________

City: _________________________ State: ____ Zip: _________

Country: ____________________

3. Phone: (_____) _________________ Fax: (_____)

4. Contact Person: ________________________________

Title: __________________________________

Phone: (_____) ________________

5. Name of applicant organization's chief executive officer/executive director:

_______________________________________________________

6. Names of applicant organization's officers of the board of directors:

Chairperson: __________________________________________

President: _____________________________________________

Secretary: ____________________________________________

Vice President: _________________________________________

Treasurer: ____________________________________________

7. Applicant organization's fiscal year begins: ________________

8. Indicate the program area or fund within the Foundation for which this application should be considered:

Arts

Education

Jewish Life and Learning

Swedish Life and Learning

Promoting Liberty

9. Title of project: ______________________________________

10. Dollar amount requested: $0.00 (Year 1: Year 2: Year 3: )

11. Date project will start: ___________________

12. Date of application: ___________________

13. Signature of CEO or Board Chairman:

__________________________________

 

This form along with the other items required in the application procedures section of this website may be mailed to:

Einhorn Family Foundation
8205 N. River Road
Milwaukee, WI 53217