MGWV Community Giving Application

Mardi Gras Casino & Resort Community Giving Application

APPLICANT INFORMATION
Application Date*
Name of Organization
Address*
Street AddressAddress Line 2CityStateZip Code
Name of Contact Person*
FirstLast
Title or Position
Telephone*
(Include Area Code)
Fax Number
(Include Area Code)
Email
Website
Is your organization an IRS 501(c)(3)?*
- Yes
- No
Briefly describe the mission of your organization*
Briefly describe the history of your organization*
Please provide a list of Mardi Gras Casino & Resort Employees involved in your organization and their roles:
Employee Name Employee Role

You can list up to 10 employees
GRANT REQUEST INFORMATION
Program/Event/Initiative Title:
Date or Start Date of Program/Event/Initiative:
Location(s):
Geographical Areas Served:
How many people are expected to attend Program/Event:
- Below 50
- 50-100
- 101-250
- 251-500
- above 500
Requested Amount:
Requested Deadline Date for Amount:
Projected Total Project Cost:
Specificially, how will the donation be used?
Description of Program/Event/Initiative:
Objectives of Program/Event/Initiative:
How does this effort address a community need?
Please describe how the community and population will benefit.
Will Mardi Gras Casino & Resort be recognized at your Program/Event?
- Yes
- No
If yes, how?
What form(s) of recognition or promotional opportunities would Mardi Gras Casino & Resort receive?
- Public Service Announcement
- Display Mardi Gras Casino & Resort brochures/print materials
- Program Ad
- News Releases
- Mobile Kitchen
- Signage
- Table/Booth
- Corporate Tickets
- Website Acknowledgement
- Other:
If Other, how?
Will Mardi Gras Casino & Resort employees have opportunities to participate/volunteer?
- Yes
- No
If yes, how?
What other organizations are you approaching for funding for this Program/Event/Initiative?
If you have ever received funding/support from Mardi Gras Casino & Resort in the past, please list name of event, date(s), brief description and contribution amount:
AUTHORIZATION
The undersigned certifies that they are authorized to represent the organization applying and that the information contained in this application is accurate. The undersigned agrees that if the application is approved and funds are awarded:
- the funds will be used for the purpose outlined in the award letter and may not be expended for any other purposes;
- information about the organization and the funds awarded may be used by Mardi Gras Casino & Resort in any published and/or collateral materials; and
- the funds will be used without discrimination on the basis of race, religion, age, gender, sexual orientation, origin, disability, veteran status, marital status or other factors.
Grant recipients may be asked by Mardi Gras Casino & Resort to be featured in stories about the grant in Mardi Gras Casino & Resort's newsletter on their Website, Facebook and Twitter, in a letter to board members and customer database and other outlets as are deemed appropriate by Mardi Gras Casino & Resort. The organization may be asked to sponsor a press event for the presentation of the grant check.
Signature*
FirstLast
Date*
*If contacted, you will be asked to furnish a copy of your current IRS determiniation letter indicating 501(c)(3) tax exempt status.

APPLICANT INFORMATION

GRANT REQUEST INFORMATION

AUTHORIZATION

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