Grantseeker Information Form

Please use this form to provide us basic information about your organization. We use the information to make a preliminary determination whether your organization’s charitable status, mission and activities may qualify it for potential consideration.

This is not a grant application. We do not accept unsolicited grant applications.

Before you decide to submit this form please be sure to review our website. In particular, read the Our Priorities - Education and Our Priorities - Scientific Research pages under the Who We Are section and the pages under the Grantseekers section.

To submit this form:

  • Complete the form. For Yes/No and Check One questions place an X in the appropriate boxes.
  • Save and print the completed form for your records. Thenemail the formto:

We will acknowledge receipt of your form via email within five business days. If you do not receive a reply or have problems using this form, please call us at 312-799-4500.

Your Contact Information

Date Submitted
Your Name
Title
Organization
Street Address
Suite or Mail Stop
City
State / Province
Zip / Postal Code
Country
Telephone
Fax
Email Address
Website URL

Qualification Questions

  1. Have you read our Grantmaking Guidelines, including particularly the section entitled Geographic Considerations?

Yes / No
  1. If your organization is based in the United States of America, is it registered under the Internal Revenue Code as a Section 501(c)(3) organization or equivalent?

Yes / No

Grantseekers outside the U.S. may be considered if they can provide a written legal opinion or affidavit stating “charitable equivalency” to a qualifying U.S. organization or if they are carrying out similar charitable or educational activities.

3. The Brinson Foundation will not consider grant inquiries from organizations that request funding for activities that attempt to influence public elections, voter registration, political activity, lobbying effortsor programs that promote religious faith, include religious content or are based on religious or spiritual values. Does your organization engage in any of the following activities?

Yes / No / Activity
Voter Registration*
Lobbying (i.e., attempts to influence legislation)*
Political Campaign Activity or other Attempts to Influence Public Elections
Promote a Religious Faith, Religious or Spiritual Values or Include Religious Content

*If you answered Yes to any of the above activities noted with an asterisk, The Brinson Foundation may consider your organization, provided thoseactivities arewithin permitted limits for a Section 501(c)(3) organization and if no portion of the Foundation’s grant will fund such activities. Please explain the activities below.

4. What type of grant is sought by your organization?

Check One / Type of Grant
Project – We generally prefer to fund specific projects for new grantseekers.
General Operating – Certain operating support requests may be considered.
Endowment – We do not fund endowments at this time.
Capital Campaign – We do not fund capital improvements at this time.
Fundraising Event – We do not support fundraising events at this time.
  1. The Brinson Foundation will not consider grant inquiries from organizations that are limited to members of a specific race, gender, religion or ethnic group (excluding medical research programs where such limitations may be necessary and appropriate). Is your organization’s mission or its activities limited in any of these ways?

Yes / No / Basis
Race
Ethnicity
Gender
Religion
Sexual Orientation

6. We are currently interested in programs in the following focus areas. If your inquiry falls within one of these areas, please check the relevant box and then proceed to questions 7 through 10. If not, we recommend that you monitor our website for updates to our areas of interest.

Check One /
Priority and Focus Areas
Education

Financial Literacy

Health Care Career Development
High School, College and Career Success
Liberty, Citizenship and Free Enterprise
Literacy
Science, Technology, Engineering and Math (STEM)
Student Health
Scientific Research (Physical Sciences)
Astrophysics
Cosmology
Evolutionary Developmental Biology
Geophysics (Plate Tectonics, Seismology, and Volcanology)
Medical Research
We are not accepting inquiries in this priority at this time.
  1. Describe your organization’s mission in 5 sentences or less.

8. Provide a brief history of your organization.

9. Describe the project for which you seek funding in 5 sentences or less.

10. Provide any other brief comments you believe are pertinent to helping us determine whether your organization may qualify for potential consideration.

Thank you for completing and submitting this form.

Version: 04/20/17 Page: 1 of 4