Nonprofit Grant Application

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* denotes required field.

Organizational Information

Organizational Information

US Federal TIN or EIN*

Organization website*

Detailed Information

Mission & organizational overview*

Describe the population that
you serve*

What will the computers be used for?*

# Desktops Requested*

# Monitors Requested*

# Laptops Requested*

Impact and reach*

An InterConnection Technology Grant consists only of computers and peripherals (mice, keyboards, etc).
Recipient organizations are responsible for shipping costs – estimated up to *$40 per desktop (and included accessories) and *$20 per laptop and any additional operating costs and maintenance.

*Shipping fees will vary

Please provide a detailed proposed budget with the following items:

Annual cost of Internet Service/Electricity

Annual cost of IT maintenance

Budget sources*

Maintenance plan*


Evaluation plan*

* required field