Capital Improvement Grant Reimbursement

Reimbursement Request Form

Cover Letter(Required)

This is your chance to tell us how great the project has been received and feedback. Let the committee know the impact and successes.

Accepted file types: pdf, doc, Max. file size: 2 MB.

24-08-2026

Legal Name of Organization(Required)

Contact Person Name(Required)

Title / Role(Required)

Address(Required)

This is where correspondence and reimbursement check will be sent .

Street Address City State ZIP Code

Cell Phone(Required)

Email(Required)

Type of Non-profit(Required)

Non-profit ID #(Required)

Project Information

Name of Project(Required)

Project Completion Date(Required)

Total Project Cost(Required)

Amount requested for reimbursment(Required)

Maximum ask is 50% project cost.

Budgeted Expenses

This section is undetermined how to best to it. Is there another way? For each invoice or receipt we need the Vendor, Date, proof of payment, a way to upload this with ultimately the total

Expense List(Required)

Download your numbered expense list with totals here. Make sure date and payment information is included on each. Such as: Check #,, ACH-Bank Name, Credit card (last 4 digits) Please make sure all items are in place.

Accepted file types: pdf, Max. file size: 2 MB.

Paid Recipts(Required)

Download your numbered paid receipts in the order of your expense list. Make sure date and payment information is included on each. Such as: Check #,, ACH-Bank Name, Credit card (last 4 digits)

Accepted file types: pdf, Max. file size: 20 MB.

Proof of Attribution and Project Photos

Project Attribution Signage Photo(Required)

One upload required.

Drop files here or

Accepted file types: jpg, pdf, Max. file size: 5 MB, Max. files: 2.

Additional Project photos

Drop files here or

Accepted file types: jpg, pdf, Max. file size: 5 MB, Max. files: 4.

Final Step

Signature(Required)

Date

CAPTCHA

Lets move on to the next step!

Grant Guidelines

More Information

Thank You!