Apply Online

The Kimball Foundation no longer accepts applications by mail. This is a "print friendly" version of the form, that you can use as a tool to help you collect the data that you will need to apply on-line. To submit an on-line application, use this form.Fields marked with an asterisk are required.

Please review the application carefully. You may find it easier to print the form out, collect all of the required information, and then return to the web site later to complete it.

General Information:
Name of Organization*:
Contact Name*:
Address:
City:   State:  Zip Code:
Email Address*:
Phone: Fax:

Statement of Intent:
(Please make this concise. Form only allows 5000 characters, including spaces.)



For Previous Grant Recipients:
If you have been awarded a gift by the The Horace A. Kimball & S. Ella Kimball Foundation previously, we would like you to share how you have used the funds. If you have never been awarded a grant by the foundation, you may leave this field blank.


Verification of 501(c)(3) and 509(a) status:
501(c)(3) Id #*:  Date of Issuance: or
509(a) Id #:  Date of Issuance:

If this is the first time a request has been made to the Kimball Foundation, please indicate your intent to provide copies of 501(c)(3) and 509(a) verification documentation by mail to the Foundation.
Copies of verification documents will be sent to the Foundation:

Financial Information:
All figures should be rounded to the nearest dollar. The Kimball Foundation realizes that your financial information could have different headings and sub headings - please do the best to fit them into the following areas to make them as standard as possible.

Balance Sheet as of (date)

Current Assets
  Cash
  Accounts Receivable
  Inventories
  Prepaid Expenses
    Total Current Assets
Property and Equipment
  Land
  Building and Improvements
  Furniture and equipment
  Less accumulated depreciation
    Net of Property & Equipment
Other Assets
Total Assets (should equal total Liabilities & Equity)
Current Liabilities
  Accounts Payable
  Accrued liabilities
  Short Term Debt
    Total Current Liabilities
Long term debt
Other Liabilities
Equity
Total Liabilities and Equity (should equal Total Assets)
Additional Comments on the Balance Sheet:

Income Statement for period ended: (date)

Revenues & Support**
  Grants
  Contributions
  Donations
  Earned Revenue
  Interest Income
  Miscellaneous Income
    Total Income
Expenses
  Salary of highest paid full time employee*
  Salary of 2nd highest paid full time employee*
* These salaries are those of employees of the organization that will benefit from the gift, if awarded
  Wages and other salaries
  Payroll taxes and benefits
  General Administration Expenses
  Miscellaneous Expenses
    Total Uses of Income

Number of full time employees:
Number of part time employees:
Total number of paid employees:
Number of volunteers:

**Please use the following space to list specific contributors (i.e., other foundations, etc.) and provide any additional comments regarding Revenues & Support:

This is only a "print friendly" version of the form, that you can use as a tool to help you collect the data that you will need to apply on-line. To submit an on-line application, use this form.