The Frederick & Margaret L. Weyerhaeuser Foundation
Application Cover Form

Information Requested
Organization Name:
Organization Address:
URL of Organization:
Telephone #:
Email Address:
Contact Person:
Title:

Finances
Total Agency Budget For Last Fiscal Year:
Total Project Budget:
Amount Requested From
The Frederick & Margaret L. Weyerhaeuser Foundation:
Other Funding Sources

Field of Interest (check only one)
Adolescent & Childhood Mental Health
Youth Conservation Education
Service Learning
Innovative Teaching Techniques

Project Summary
Title of Program:

Please summarize your project or request in less than 200 words.

Have you received a Frederick & Margaret L. Weyerhaeuser Foundation grant in the past? Yes No
If Yes, Year(s) Grant(s) Received

Have you done this project before? Yes No

Is this project a model which has been replicated elsewhere? Yes No

Do you expect to have ongoing funding needs for this project? Yes No

Please print and submit this form along with your Letter of Intent, a one-page budget summary and your IRS exempt status letter before the September 1st deadline.