Please note that this sample application is for reference use ONLY. You must log in to actually submit a proposal.

Contact Information

* indicates required field

Please provide the following information so that we may contact you regarding your proposal.

Organization Information

* indicates required field

Please provide the following information about your organization.

Please answer "Yes" if your organization lacks its own tax ID or is applying for funding using another organization's tax ID. Funding will be provided to the In Care Of organization.
Please answer "Yes" if your organization does not have a tax ID or NCES number, or is applying for funding using another organization's tax ID or NCES number. Funding will be provided to the In Care Of organization, which may be a Fiscal Agent.
Address of the recipient organization
Your organization's background, history and/or mission statement
2000 character maximum

Proposal Information

* indicates required field
(MM/DD/YYYY)
Please indicate the number of months of support you are requesting. If you don't have an exact fit to choose from please pick the next largest value.
(MM/DD/YYYY)
(MM/DD/YYYY)

List your strategies, etc (please describe your program, how you will implement it and measure results, and how it fits within Verizon's strategy.)
2000 character maximum


Provide estimated projections of the metrics you plan to track. If a metric is not applicable, enter 0.
Description Target Value
Please provide a breakdown by percentage of the genders that this proposal will work to support.
%  
%  
Please provide a breakdown by percentage of the ethnicities that this proposal will work to support.
%  
%  
%  
%  
%  
%  

$0.00
Direct costs are related to activities or services that benefit a specific project. They must be costs that are directly attributable to the project. Click here for examples.
$0.00
If you included totals in the "Other" line item(s) above please briefly describe them here.
Please enter N/A if not applicable
200 character maximum
500 character maximum
500 character maximum
500 character maximum
500 character maximum
500 character maximum

Please provide any other information that will be helpful to your request.
1000 character maximum

First and last name of the individual we should contact regarding updates on your program's progress towards your stated goals.

Organization Certifications

* indicates required field
2000 character maximum
2000 character maximum
2000 character maximum
2000 character maximum
2000 character maximum
2000 character maximum