MARCONI Grant Application

Organization Leading the Proposed Project (Sponsoring Club)

Organization Name *

Mailing Address *

City *

State *

Zip Code *

Phone (with area code) *

Primary email *

Alternate email *

Organization President *

include call sign if applicable

Organization Treasurer *

include call sign if applicable

Participating Organization (Client Club 1)

Organization Name *

Mailing Address *

City *

State *

Zip Code *

Phone (with area code) *

Primary email *

Alternate email *

Organization President

(include call sign if applicable)

Organization Treasurer

(include call sign if applicable)

Participating Organization (Client Club 2)

Organization Name

Mailing Address

City

State

Zip Code

Phone (with area code)

Primary Email

Alternate Email

Organization President

include call sign if applicable

Organization Treasurer

include call sign if applicable

Participating Organization (Client Club 3)

Organization Name

Mailing Address

City

State

Zip Code

Phone

Primary Email

Secondary Email

Organization President

include call sign if applicable

Organization Treasurer

include call sign if applicable

Project Leadership

Project Leader *

include call sign if applicable

Project Leader Mailling Address

Project Leader City

Project Leader State

Project Leader Zip Code

Project Leader Phone

Project Leader Primary Email

Project Leader Alternate Email

Proposal Preparer

Proposal Prepared by *

include call sign if applicable

Mailling Address *

City *

State *

Zip Code *

Preparer Phone *

include area code

Preparer Primary Email *

Preparer Secondary Email *

Project Details

Project Name *

Project Summary *

250 words or less, include audience, duration, location

Project Impact *

250 words or less-outcomes for org, community and Amateur Radio

Project Community Support *

250 words or less - Please describe the amateur radio community (clubs and/or individuals) and non-ham stakeholders you have partnered with to reduce risk and maximize project success

Project Vision *

500 words or less - Please describe the short (12-24 month) and long (2+ years) term impact you foresee if this project is established with ARRL Foundation funding. How do you believe this project will remain sustainable and grow/expand over the same time

Other Project Funding *

IMPORTANT: Preference given to organizations conducting local fund raising;Include source, date, amount, purpose for local grants

Other ARRL Foundation grants received *

Date, amount and purpose for each

Total Project Budget *

• Indicate the inclusion of an existing MARCONI model and pre-packaged tools

Total Grant Request Amount *

This amount should be included in the full project budget amount

Budget Detail File *

Upload excel file of grant request amount. Excel budget detail file must be included with application

Budget Narrative *

(Explain fees, equipment, training, printed material and misc. purchased or leased for each organization in 500 words or less)

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MARCONI Grant Application

MARCONI Grant Application

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