REACH NEW HEIGHTS
GRANT PROGRAM

Organization Contact: *

First Name

Last Name

Organization Mailing Address *

Please input where the organization receives mail.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Physical Address *

Input the physical address of the organization.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Phone Number *

(###)

###

####

Is the organization registered with Candid/GuideStar? *

Candid/GuideStar provides information that helps nonprofits find funders to support their work. Conversely, funders look to Candid/GuideStar to verify and research nonprofits that are aligned with their priorities.

Yes

No

Select the community that this grant request will benefit: *

Bakersfield, CA

Bishop, CA

Boron, CA

California City, CA

China Lake, CA

Kernville, CA

Lake Isabella, CA

Lone Pine, CA

Ridgecrest, CA

Tehachapi, CA

Additional Information, Acknowledgement & Certification *

If your grant application is chosen to move forward in the grant award process, we will request the following: • Tax Exempt Status Letter: Copy of your organization’s 501(c)(3) tax-exempt status letter. • W-9 Form: Signed and dated Taxpayer Identification Number and Certification. • List of your organization’s Board of Directors, including names, titles, and affiliations. This organization is a 501(c)(3) non-profit organization. I am authorized by the above organization to apply for an AltaOne Foundation Reach New Heights Grant.

Acknowledgement - I certify that the above information is true and correct, that the organization is a 501(c)(3) non-profit organization, and I have authorization to apply for this grant on it's behalf.