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Grants Application – Special Purpose
GSB Sponsorship Request
Step
1
of
4
25%
Organizations may request a Guilford Savings Bank Fund sponsorship for events occurring in calendar year 2022. Please be sure to attach any additional supporting forms as necessary, such as details of all sponsorship levels, ticket prices, and applicable details. Please do not print applications forms as only digital submissions will be reviewed. If more information is needed, we will contact you.
Organization Name
(Required)
EIN #
(Required)
Applicant Tax Exempt Status
Sponsorship grants are awarded to 501(c)3 and 170(c)1 organizations. If your organization does not qualify as either, a fiduciary agent may be required to qualify for an award. Please contact Thayer Talbott at Thayer@MiddlesexCountyCF.org for information and to obtain the Fiduciary Agent form.
501(c)3
170(c)1
Other
Application Contact Name
Application Contact Email
Applicant Contact Phone Number
Event Title
Amount Requested
(Required)
Please enter a number from
0
to
3000
.
Event Information
Event Description
Please include information about the event, including all available sponsorship levels, ticket prices, audience demographics, and other applicable details.
Event Start Date
Month
Day
Year
Event Start Time
Hours
:
Minutes
AM
PM
AM/PM
Event End Date
Month
Day
Year
Event End Time
Hours
:
Minutes
AM
PM
AM/PM
Attachments
Documents MUST be uploaded in PDF file format only. Please include an event budget detailing estimated revenue and expenses, a Board of Directors / Trustees with professional affiliations, and any other applicable details regarding the event and the community impact.
Drop files here or
Select files
Accepted file types: pdf, Max. file size: 10 MB.
Impact
Donation Beneficiaries - Who benefits from the sponsorship proceeds?
Number of People Benefited
What percent of beneficiaries are low/moderate income?
Please enter a number from
0
to
100
.
Impact Activities Supported
Affordable Housing
Community Service
Economic Development
Revitalization/Stabilization
Underserved/Economically Disadvantaged
Unknown/Other
Select All
Impact Areas
Select only those directly associated with your responses to Number of People Benefited
Chester
Clinton
Cromwell
Deep River
Durham
East Haddam
East Hampton
Essex
Haddam
Killingworth
Middlefield
Middletown
Old Saybrook
Portland
Westbrook
New Haven County
New London County
CRA Details
CRA Eligible
Unknown
Yes
No
Partial
CRA Qualifying Rationale
Advertising
How will this award be acknowledged?
Advertising
Dinner Attendee
Tickets
Other
Select All
Advertising Deadline
Month
Day
Year
Advertising Information
Attachments
Drop files here or
Select files
Accepted file types: pdf, Max. file size: 10 MB.
All attachments MUST be in PDF format.
Organization Information
Executive / CEO / President Name
First
Last
Mailing Address
Street Address
Address Line 2
City
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South Carolina
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Tennessee
Texas
Utah
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State
ZIP Code
49 Main Street
Middletown, CT 06457
t: 860.347.0025
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