Before completing this form, please review the Corporate Giving Program Guidelines and Procedures to see if you qualify. You will be required to submit both a W-9 and a copy of your IRS tax exemption letter to be able to complete this request. Send PDF documents to

Fields marked with an asterisk (*) are required.

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Section 1: Applicant Information


Section 2: Project Information

Other Sources of Funding (amounts to be provided by other sources in addition to amount being requested of ACT.)

Deadline for funding decision (please apply at least 60 days prior to deadline):*


Section 3: Project Description

Please refer to guidelines regarding funding restrictions. Organizations are strongly encouraged to submit an annual funding request rather than multiple requests throughout the year.


Section 4: If You're Awarded Funding

We'll need an address for where to send the funds.

If this address is different than your organization address, please complete the fields below.