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Site Visit Sign-Up? (Applicable only to the special program grant)

Send immediately! Please submit no later than June 9, 2010.

A member of the Board of Directors of the Charles D. Jacobus Family Foundation will make a visit to your organization after we receive your full application. Site visits will be made during summer. Please pick three different dates and times, from the available dates and times listed below, that your organization would be avaliable for a visit. We generally allow one hour per visit.

Please plan the site visit around a program or an activity for which your organization is seeking funding. If none of the dates below are appropriate, please email foundation@jacobusenergy.com as I can be flexible. (For example: some programs meet only in the evening - I will work with you to find an evening that works.)

Please fill this out and submit electronically, or print out a hard copy and fax to Missy MacLeod at (414) 359-1357 as soon as possible. If you have any questions, or if these times are not convenient, please call (414) 577-0252.

Available dates in 2010 (please click on three available dates and the times that would be convenient
):

COMING SOON!

June 22 11:00 am 1:00 pm 3:00 pm
June 23 11:00 am 1:00 pm 3:00 pm
June 24 11:00 am 1:00 pm 3:00 pm
June 29 11:00 am 1:00 pm 3:00 pm
June 30 11:00 am 1:00 pm 3:00 pm
July 1 11:00 am 1:00 pm 3:00 pm
July 6 11:00 am 1:00 pm 3:00 pm
July 7 11:00 am 1:00 pm 3:00 pm
July 8 11:00 am 1:00 pm 3:00 pm

Contact Name
Email Address:
Organization Name:
Phone Number at Visit Location:
Address of Visit Location:
 
Please have the following ready for our visit if not already submitted. Please check if this item is on your website.
1. Most recent audit report.
2 Copy of your most recent Federal Tax Form 990 and/or annual report.
3. Budget for the program for which you are requesting a grant.
4. Your organization's 501(c)(3).