ECARS Grant Application

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Fill out the Grant Application shown below, then print the form.  Do not close this webpage until you know the form has printed out as you want it.  You may want to 'Print to PDF' in order to create an electronic copy of the application.

* Required data

Applicant Organization Information:

Date of Application   
Organization Name
Mailing Address:
     Street Address *
     City *
     State *
     Zip Code *
Telephone (with area code)*    (use format of (999) 999-9999)
Primary email address *
Alternate email address  
Website URL  

Project Information:

Project Name *

Project Summary *

Project Impact *

Project Measures *
(metrics and statistics to be employed to demonstrate the impact of the project)

Key Personnel:
(Include call signs if applicable)

Organization President *
Organization Treasurer *
Project Leader *
Proposal Prepared by *
Preparer email *
Preparer telephone (with area code) *

Financial Data:

Total Project Budget (including requested grant) *
Total Grant Request Amount *
(to include how the grant funds will be used.  Spread sheets may be forwarded with the application.)

Either mail or email the Grant application to the Grants Administrator at:
Vic Klein, WA4THR
163 Frederick Rd
Paxinos, PA  17860

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