Foundation for Community Justice

Living Room Grants

    REFERRAL SOURCE INFORMATION

    Person making referral:
    Phone #:
    Email address:
    Referring organization:
    Organization address:
    How do you know the person you are referring?
    How long have you known the person you are referring?

    REFERRED RECIPIENT

    Name of referred recipient:
    Age:
    Gender identity (optional):
    Race/ethnicity (optional):
    Best way to contact recipient:

    MINI-GRANT INFORMATION

    Amount requested (up to $75):
    Date of request:
    Please describe how the proposed mini-grant fulfills the Foundation’s mission.
    How will a mini-grant change the recipient's circumstances?
    Will a mini-grant now be a temporary stop-gap for an ongoing need?