Church of the Epiphany - Grant Application
Fiscal Year 2019 - 2020
To be considered for a grant, please answer the following questions about your organization
and limit your response to three pages. The application must be received by the Church of the
Epiphany no later than Friday, February 1, 2019. Please return the application (by email or
US mail) to the attention of:
Laurie Weeda
Church of the Epiphany (804) 794-0222
11000 Smoketree Drive LWeeda@epiphanychurch.org
N. Chesterfield, VA 23236
1. Contact information Person completing the application, Title
Name of Organization Telephone number
Address of Organization Email address
Telephone number Signature
2. Please share the Mission Statement of your organization and how it relates to
Epiphany’s Human Concerns Mission (shown below) *.
3. Grant amount requested this year.
4. If you received a grant last year, please explain specifically how Epiphany funds were
used. How many people were served by these programs? Please include a testimonial
or concrete example of the impact the grant has made on the organization, a program,
individuals or families.
5. What is the purpose of requested grant funds? Please be sure to outline how your
project specifically benefits clients in the areas of food, housing, health and welfare.
6. How are Epiphany parishioners currently involved in your organization? Who are they?
How may we be more involved with your organization?
7. How would you like to be involved at Epiphany? Would you be willing to participate in a
program (an evening or weekend “fair”) at Epiphany to bring awareness to your
organization? Your ideas are invited (type of event and time of year).
8. Please supply the following information from your current budget and submit a copy of
your most recent IRS Form 990, excluding attachments.
If your program is part of a larger organization, please supply numbers relative to your
program if available, not the larger organization budget.
Total Budget
Grant Request $ % of Budget
Cash Balance $ % of Budget
Salaries $ % of Budget
Reserves $ % of Budget
Capital Expenditures $ % of Budget
Fundraising
Income $ % of Budget
Expenses $ % of Budget
Have there been significant changes in your operations or in your goals in the last year that
have affected your financial situation? If yes, please explain.
*Epiphany’s Human Concerns Mission: We resolve to...INCREASE awareness among
community members of the need to respond generously to any of God’s people who are
suffering, whether it be from physical or emotional illness, deprivation of basic needs, loss of
dignity, or separation from meaningful relationships.
CC BY-NC-SA 4.0