CT Chapter of US Lacrosse Grant Application Form
 

Section I - General Information

Title of Project: _______________________________________

Organization Requesting Grant: ______________________________________

Project Leader: _______________________________________

Telephone/E-mail: ___________________/___________________

Section II - Coordinator Authorization

CT Lacrosse Foundation will not accept applications without signed authorization.

Signature: _______________________________

Organization: _______________________________

Section III - Project Scope

Please indicate if this application is for an independent project or if it is linked to another

application being made to US Lacrosse or CCUL.

Independent Project_______ Collaborative_______

If collaborative, please identify the related application being made to CCUL: ________________________________

Section IV - Project Beneficiaries

Targeted population to benefit from this grant: _____________________________

Grade level: _____________________________

Section V - Project Summary

Please write a brief summary of the project (attach summary to this form), including the following information:

Goal: describe the ultimate goal of this project

Motivation: what prompted your interest in or need for this project

Activities: describe the procedures and/or activities for implementing or performing this project. 
Include materials, timelines, outside consulting and travel requirements.

Please indicate if this is a continuation of a previously funded grant.

Section VI - Project Budget

Project Budget and Estimated Costs (please attach any supporting detail)

Supplies and Materials: ___________________________________

Equipment: ___________________________________

Personnel: ___________________________________

Travel: ___________________________________

Consulting or support fees: ___________________________________

Total: ___________________________________

Section VII – Alternative Funding Source

Are you applying elsewhere for funding?

______________________________________________________________________

Will any form of matching funds be available to complement potential funding from CCUL?

______________________________________________________________________

______________________________________________________________________

Section VIII - US Lacrosse Membership

All grant recipients are required to provide proof that its members are US
Lacrosse members at the time of the Grant Application OR prior to distribution
of the grant award.
 

Section IX – Project Evaluation Requirement

I certify that all of the above information is accurate to the best of my ability.

____________________________ ___________________________

Signature                                                Date
 

Please feel free to submit any additional information to support your proposal.
Grant applications will be reviewed twice per year.
Grants applications deadlines are January 31st and September 30th.
Forward proposal to:

Mark J. Duclos

Grant Committee Chair/CT Chapter of US Lacrosse

45 Bay Hill Drive

Bloomfield CT 06002

If you have any questions or need assistance, call Mark J. Duclos, 860-983-5630