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SilverConnect Grant
Is your organization exempt under 501(c)(3)?
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yes
no
Is this grant application for a program or service specifically focused on older LGBTQ+ people?
*
yes
no
What is the location and primary service area of your organization?
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How did you hear about us?
Twitter
Instagram
Facebook
LinkedIn
Newspaper
Other
What is the proposed timeline for the program or service for which you are seeking funding?
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Urgent: Within 3 months
Soon: Within 6 months
Upcoming: Within 12 months
Organization's Legal Name
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Primary Contact - First Name
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Primary Contact - Last Name
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Primary Contact - Email Address
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What is your role at the Organization?
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Does your Organization have a website?
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Yes
No
Your website url?
Primary Contact - Phone Number
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Organization's Federal Tax ID Number
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Organization's address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
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Burundi
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Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
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Cook Islands
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Ethiopia
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Guyana
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Italy
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Japan
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Jordan
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Kenya
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Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
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Libya
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Lithuania
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Maldives
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Mongolia
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Montserrat
Morocco
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Myanmar
Namibia
Nauru
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Netherlands
New Caledonia
New Zealand
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Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Please describe the geographic location of programs and services offered by Organization
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Describe the program or service for which you are seeking funding
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How does this program specifically address the critical needs of older LGBTQ+ people?
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Is you organization in compliance with all federal, state and local tax filings, including payroll and property taxes?
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Yes
No
Is Organization in compliance with all federal, state and local laws, statutes and ordinances?
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Yes
No
Is program new or existing?
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New
Existing
How long has the program been up and running?
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1 year to 3 years
3 years to 5 years
more than 5 years
What are some examples of the outcomes of program to date?
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How much total funding are you seeking for this program? (Please submit a proposed budget with the application.)
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Please provide the planned budget for the proposed program or service. We understand that it might be necessary to augment existing staff and/or to add space to deliver a new or expanded program or service. However, we seek proposal budgets that strike a more balanced allocation of funding to ensure that members of the TGNCNB community will be directly enriched by the delivery of the proposed program or service. Writing your grant proposal program budget accordingly would make it more competitive for funding.
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Max. file size: 50 MB.
Please provide your organization's annual budget.
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Max. file size: 50 MB.
Please provide your organization's most recently filed Form 990
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Max. file size: 50 MB.
Please provide your organization's IRS Determination document(s).
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Max. file size: 50 MB.
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