Mini-Grants Form

 

All applications must be RECEIVED by 12:00 AM, Friday June 01, 2012. . Grants will be awarded on or about September 1, 2011. Recipients will be notified of grant approval in writing. Due to the number of applications received, only recipients will be notified.

 

Your mini-grant form has been sent. Thank You.

  * Required Field  
Name *
 
Address *
City *
State *
Zip *
Daytime Phone *
Evening Phone
E-mail *
Are you a *





Amount Requested *
($1000 maxiumum)

If you are serving persons with autism:
Name of organization, agency, or program
Address
   
Please attach a one page description or use the form below to describe how the funds will be used and how that will directly benefit or impact persons with autism within Connecticut or their families. Please also attach any brochures, catalogues or other descriptions of the items or services to be purchased. Please indicate whether the grant request is for a new item, repair or retrofit of an existing item or reimbursement for an item previously purchased. Incomplete applications will not be considered.

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