Apply Online

The Kimball Foundation realizes that some charitable organizations are not equipped with the necessary computer related equipment to make application "on-line". As a result, the Foundation will still take applications by mail (click here for instructions), however we will not be able to process these as rapidly. Hence, we encourage all applicants to use the Internet wherever possible. 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 3200 characters, including spaces.)


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
  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:

When you submit this form, you will be redirected to a confirmation page, which indicates that the form has been properly sent. It may take a few moments for your submission to be processed; please be patient.
You will not receive an e-mail confirmation of your submittal.