Thank you for your interest in the Assurant Foundation and the support we provide to charitable organizations in the five boroughs of New York City. The Foundation awards approximately 10-15 grants per quarter, with an average grant of $2,500 and a maximum amount of $5,000. Our giving focus areas are Health & Wellness (e.g. prevention, family health), Homes Property (e.g. managing everyday risks, making a fresh start, shelters), and Hometown Help (e.g. local community-based charities, including education).

An application for qualified applicants is provided below. Please complete the application and include all required documentation. Send the completed proposal by the quarterly deadline to:

Taryn Moskowitz
Corporate Communications Consultant
Assurant, Inc.
One ChaseManhattanPlaza, 41st Floor
New York, NY10005
Deadlines for grant requests to the Assurant Foundation are:

1Q 2011-Feb. 16, 2011
2Q 2011-May 16, 2011
3Q 2011-Aug. 16, 2011
4Q 2011-Nov. 16, 2011

Applications must be received by the posted quarterly deadline to be considered for direct grants from the Assurant Foundation.

Section I

Name of organization:______

Federal Tax Identification Number:______

Address:______

City:______State:______Zip:______

Telephone:______Fax:______

Organization Web Address (if applicable):______

Primary Contact (and title):______

E-mail Address:______

Amount of Request:$______Date of Application:______

2. Name of project/program for which support is requested. (Note: The Assurant Foundation does not provide grants to support general operations or capital campaigns).

______

3. Please provide a brief description of the program/project: ______

4. Does the request address one of the Assurant Foundation funding focus areas? Y N

If yes, please select one (circle):

Health & WellnessHomes & PropertyHometown Help

5. What are the timelines for the project/program?

______

6. What is the budget for the program/project? ______

______

7. How does this project address a community need? Please describe the community or group(s) that will benefit. ______

______

8. Briefly explain how your organization measures/evaluates the success of the program/project and demonstrates the impact of resources made available? ______

______

Section II

Please enclose one copy of each of the following items:

  1. Cover letter
  2. A copy of your current IRS determination letter indicating tax exempt 501c(3) status
  3. Annual Report or other materials summarizing activities of the organization
  4. Budget for the program/project for which funding is requested, along with a summary of current year operating and expense budget for the organization
  5. Most recent audited financial statements from the IRS Form 990