Application – For Projects Up To $500

Please note that your entries will not be saved if you leave this page! Please have all information ready to fill in the blanks as well as all of the documents to download at one time.

Name of Organization:
Amount of this Request:
Project Name:
Project Discription (one sentence):
Year Organization Incorporated:
Chief Executive Name and Title:
Contact Name and Title if Different:
Contact E-mail Address:
Website:
Phone:
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Fax:
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Address:
Geographic Area Served:
Time frame in which funds will be used:
Total Project Cost:
This request is what % of TOTAL PROJECT COST:

Financial Information

(If your program is part of a large organization, i.e. school district or government. Please give program/project budget information only.)

Fiscal Year:
Expenditure total last fiscal year:
Revenue Total for last year:
Expenditure total expected this fiscal year:
Revenue total expected this fiscal year:
Please list the 5 single largest revenue sources/contributors and amounts for this fiscal year or last fiscal year. Individuals may be listed as anonymous.:
Required Materials - Please upload each file requested. File types accepted are, jpg, jpeg, png, gif, doc, docx, xls, xlsx, PDF

Cover letter (1 page), Proposal narrative (2 pages), and attachments may be sent via email to: susanroundhousefound@gmail.com or may be mailed to: Roundhouse Foundation, PO Box 1784, Sisters, OR 97759

Roundhouse Foundation Proposal Narrative: Limit 2 pages! Font size 11 or higher with margins .5 inch or larger

1) One paragraph summarizing your proposal.

2) Mission Statement

3) Organization background: Describe the organization’s qualifications, history of success and use of volunteers. If this project is a collaboration, please describe the other organizations involved and identify the lead agency.

4) Needs Statement: Describe the needs that will be addressed through this project. Explain how the need was identified. 

5) Project: (please include the following)

  • Who will be served? (how many, ages, geographic area)
  • How will the project meet the needs identified? Include goals, activities and timelines.
  • What is the anticipated impact and how will you measure effectiveness?
  • Please list other funding sources for this project and note if funding is secured.

File Uploads - Some applicants have had problems with uploading a PDF. It could be that the size of the document is too large. If this happens with any of your file uploads just simply email that file to us. Make it VERY clear in your email that you have applied and needed to send that file separately. Make sure to include your name or company name with the email so we can match it to the application.

Upload the Following Files

1. Project Budget - Limit one page:
2. Most Recent Financial Statement:
3. 501(c)(3) Determination Letter from IRS (not needed from public schools and government):
4. Board of Directors List (with affiliations and phone numbers):
Project Narrative
Upload Proposal Narrative:
SUBMIT YOUR APPLICATION