CT Chapter of US Lacrosse Grant Application Form
Section I - General Information
Title of Project: _______________________________________
Organization Requesting Grant: ______________________________________
Project Leader: _______________________________________
Section II - Coordinator Authorization
CT Lacrosse Foundation will not accept applications without signed authorization.
Section III - Project Scope
Please indicate if this application is for an independent project or if it is linked to another
application being made to US Lacrosse or CCUL.
Independent Project_______ Collaborative_______
If collaborative, please identify the related application being made to CCUL: ________________________________
Section IV - Project Beneficiaries
Targeted population to benefit from this grant: _____________________________
Grade level: _____________________________
Section V - Project Summary
Please write a brief summary of the project (attach summary to this form), including the following information:
Goal: describe the ultimate goal of this project
Motivation: what prompted your interest in or need for this project
Activities: describe the procedures and/or activities for implementing or performing this project.
Include materials, timelines, outside consulting and travel requirements.
Please indicate if this is a continuation of a previously funded grant.
Section VI - Project Budget
Project Budget and Estimated Costs (please attach any supporting detail)
Supplies and Materials: ___________________________________
Consulting or support fees: ___________________________________
Section VII – Alternative Funding Source
Are you applying elsewhere for funding?
Will any form of matching funds be available to complement potential funding from CCUL?
Section VIII - US Lacrosse Membership
All grant recipients are required to provide proof that its members are US
Lacrosse members at the time of the Grant Application OR prior to distribution
of the grant award.
Section IX – Project Evaluation Requirement
I certify that all of the above information is accurate to the best of my ability.
Please feel free to submit any additional information to support your proposal.
Grant applications will be reviewed twice per year.
Grants applications deadlines are January 31st and September 30th.
Forward proposal to:
Mark J. Duclos
Grant Committee Chair/CT Chapter of US Lacrosse
45 Bay Hill Drive
Bloomfield CT 06002
If you have any questions or need assistance, call Mark J. Duclos, 860-983-5630