The Simmons Foundation
A Maine Private Charitable Foundation
Application Process

Organization Name: 

Contact Name: 


Phone:                                         Fax:                          


Employer IRS No:                                           Year Organized: 

Overall Mission of your organization: (250 words max.) 

Total Organization Budget: 

Name of PROJECT to be funded (or indicate "general organizational needs"):

Specific problem to be solved or need to be addressed by Project under request (e.g. “World Hunger” is not a 
specific need. “Difficulty distributing food for those who don’t drive” would be.): 

Project description / how will project address these needs: (350 words max.)

Total project budget (what this project will specifically require within the total organization budget):


What specifically will this grant pay for (a list of needs is acceptable):

Geographic Region and Population served by Project (list ages, economic status, education levels, specific needs)

Approximate number of people to be directly served by Project: 

How will you know if Project is a success (please include appropriate data): (350 words max.)

How will you provide for on-going funding for this Project (if applicable)?

Must click on "Submit" button to send document.

Grant requests are accepted until October 15th and April 15th for the Foundation’s November and May meetings, respectively. All required materials must be received on or before 5PM on those dates. Grant requests received after 5PM on those dates will be held over for the next meeting. Grants are usually distributed within thirty (30) days after a meeting. 

Format for Grant Application Cover Sheet 
TRUSTEES REVIEW A ONE-PAGE GRANT APPLICATION COVER SHEET (below), but may also request any back-up documentation that your organization provides. In this way, they can view a synopsis of your request and then have further information if they are interested in the initial proposal. 

For this reason, you will want to make your Grant Application Cover Sheet as COMPLETE AND SUCCINCT AS POSSIBLE. We request that you use the Form below (or answer the same questions in a letter) and email it to us in addition to any supporting documentation. (Additional information will be available to Trustees at the meeting.)

If necessary, you may send some items or everything by regular mail. Following the format of the Cover Sheet will insure that your request gets the best possible consideration. Failure to follow the format, or to include required documentation, may result in delays or rejection of your request. 

Additonal Documents which MUST be attached or sent:
> Detailed Project Budget (please include any in-kind donations) 
> Copy of most recent IRS Tax-Exemption Determination Letter 
> Annual Report (if available) 
> List of current Board of Directors 
> Signed and dated Certification Letter (click here for copy)
> Any additional documentation which might help Trustees evaluate your request 
Send by regular mail to: 
Timothy Benoit, Esq., c/o Perkins/Thompson, P.O. Box 426, Portland, ME 04112
Send by email to: