TransPLUS Application

Is your organization exempt under 501(c)(3)?*

Is the organization's primary mission to offer programs and services for the TGNCNB community?*

Is the organization headquartered and providing services in the Northeast part of the U.S.?*

How did you hear about us?

What is the proposed timeline for the program or service for which you are seeking funding?*

Organization's Legal Name*

Primary Contact - First Name*

Primary Contact - Last Name*

Primary Contact - Email Address*

What is your role at the Organization?*

Does your Organization have a website?*

Your website url?

Primary Contact - Phone Number*

Organization's Federal Tax ID Number*

Organization's address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please describe the geographic location of programs and services offered by Organization*

Describe the program or service for which you are seeking funding*

How does this program specifically address the critical needs of the TGNCNB community?*

How are TGNCNB people specifically represented in leadership roles of your organization (Management, Board, etc.)?*

Is you organization in compliance with all federal, state and local tax filings, including payroll and property taxes?*

Is Organization in compliance with all federal, state and local laws, statutes and ordinances?*

Is program new or existing?*

How long has the program been up and running?*

What are some examples of the outcomes of program to date?*

How much total funding are you seeking for this program? (Please submit a proposed budget with the application.)*

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.*

Max. file size: 50 MB.

Please provide your organization's annual budget.*

Max. file size: 50 MB.

Please provide your organization's most recently filed Form 990*

Max. file size: 50 MB.

Please provide your organization's IRS Determination document(s).*

Max. file size: 50 MB.

Has your Organization received a grant from the Leonard Litz LGBTQ+ Foundation previously?*

Please write a short description of program or service for which you most recently received funding, and a snapshot of any progress made, including unexpected difficulties or challenges:*

Did our grant cover the entire cost of the program or service?*

If No, please describe other funding sources by checking the applicable box(es):

Other Foundation funding
Government grants
Corporate funding
Group or Individual giving
Existing funds
Other

Please provide an updated document showing how the funding from Leonard Litz was allocated:*

Max. file size: 50 MB.

Do you plan to continue or repeat this program or service in the future?

Please share any pictures, videos, testimonials, or other exciting artifacts from the program that you are okay with us sharing on our website:

Drop files here or

Max. file size: 50 MB.

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TransPLUS Application

Helping LGBTQ people fulfill their potential.