Each year Billy Andrade and Brad Faxon read applications from 501(c)3 Charities applying for grant funds. Please fill out the Online Application, Upload required documents, Provide your digital signature, and Hit the SUBMIT Button.

If you would rather handwrite or type your application and mail it to AFCC with required documents please, click this link to download our PDF Application.  Our address is Andrade-Faxon Charities for Children, PO Box 3305, South Attleboro, MA 02703

Name of Organization *

Date Prepared *

Email Address *

Address of Principal Office *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

When Organized *

Date and Place of Incorporation

Incorporated as an Nonprofit? *

• YES
• No

Has your organization qualified as a non-profit, tax deductible entity under the United States Internal Revenue code 501(c)3? *

• YES
• No

If No, Please enter an application date

REQUEST

Total Amount Resquested *

Is this amount for one fiscal year? *

• YES
• No

If NO, for what period?

USE OF FUNDS: *

Please outline proposed project or program, identifying both your target population and your planning method of improving that group's quality of life. Be specific. When you submit your detailed budget be sure it reflects this Use of Funds statement.

PURPOSE AND PROGRAM

State Your Organization's Objectives. *

Briefly Summarize Your Organization's Current Efforts Towards Achieving Those Objectives *

What Geographic Area Do You Serve? *

Describe Your Agency's Efforts to Collaborate with Other Organization's Whose Services Parallel, Duplicate, or Aid Your Work. *

Name and Title of Paid Staff Head *

Date of Appointment *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Prior Affiliation *

FINANCES

Please complete with respect to Applicant Organization only. DO NOT include Parent Company financial information.

Organization's Fiscal Year *

From Month/Day/Year to Month/Day/Year. For example: November 1, 2019 to October 31, 2020

Revenue Received Last Fiscal Year Excluding Capital Campaign Funds *

Use $

Total Government Revenue Received Last Fiscal Year? *

Use $

Total Expenditures Last Fiscal Year *

Use $

Total Approved Budget for Current Fiscal Year *

Use $

Salary range, including deferred compensation, for all of your organization's paid employees* *

Lowest Paid to Highest Paid From $_________________ to $________________________

List the Methods of Fund Raising, Used or Planned That Generate Your Organization's Revenue. *

For Example: (Direct Mail, Membership Solicitation, Corporation/Foundation Solicitation, Social Media Campaigns, etc.)

List Any Outside Fund Raisers and Your Payment to Them. *

Accounts Are Audited by: *

• Certified Public Accountant?
• An Auditing Committee
• Other

If You Checked "Other" Above, Please Specify Who Accounts Are Audited by:

Frequency of Audits *

Yearly, Every Other Year... not required

ADDITIONAL INFORMATION

File Upload *

Click or drag a file to this area to upload.

Please attach a copy of your U.S. Treasury ruling granting your organization status as a Non-profit, Tax Deductible Organization under Section 501(c)3

Please Mail a Printed Copy of Your Complete Audit for the Previous Fiscal Year tp Andrade-Faxon Charities, PO Box 3305, South Attleboro, MA 02703 *

• I have mailed a copy
• We do not require an Audit, but I have mailed our most recent Form 990's
• I have neither of the above, but I have mailed our internal financials for the last 3 years.

Does Your Combined Cost of Administration, Public Relations, and Fund Raising Exceeds 20% of Total Expenditures for the Previous Fiscal Year? *

• YES, It Does Exceed 20%. Please fill out an explanation below.
• NO, It Does Not Exceed 20%

If you checked YES above, Please Explain Your High Administration Expenses.

File Upload *

Click or drag a file to this area to upload.

Please Upload a List of Corporate Donors ($200.00 Or More) in the Previous Fiscal Year.

File Upload *

Click or drag a file to this area to upload.

Please Upload Your Project or Program Budget That Supports Your Use of Funds. The Amount of this Budget Should Equal the Amount of Funds Requested!

I certify That the Aforementioned And Enclosed Information Is Complete And Accurate

Person to Contact if We Have Questions *

First

Last

Person's Title

Today's Date

Home TelePhone *

MANDATORY - THIS NUMBER WILL BE KEPT PRIVATE AND ONLY USED IN CASE WE HAVE AN URGENT QUESTION.

Work Telephone

Signature *

Clear Signature

Message

Submit