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Mindy Gail, Executive Director
Tel: (818) 582-3233
E-mail: info@prsala.org

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Don Perkins Community Service Grant Application

Non-profit organizations providing services or programs (except those of an exclusively religious nature such as churches and religious institutions) located throughout PRSA-LA's chapter area are welcome to apply. This includes organizations registered as a 501(c)3 in the State of California that reside in these areas: Los Angeles County, Santa Barbara County, Ventura County and Kern County.

Application Deadline is August 31, 2011.

Please note: you are not able to save a partially completed form, so please be sure you have all the needed information before beginning, including uploadable copies of the Articles of Incorporation, Tax-Exempt Status Letter, and Annual Report.

id
date
Submitter Info
Your Name
Your Email
Organization Info
Name of Organization
Executive Director
Street Address
City
State
Zip Code
Phone Number
MISSION STATEMENT/PURPOSE OF ORGANIZATION
Purpose of Organization
GEOGRAPHIC AREA – Please detail the geographic area served by organization.
NUMBER of constituents served by organization
Annual Budget
PUBLIC RELATIONS Project / Program Summary Briefly outline the public relations objectives you want to achieve.
PR Summary
PROJECT PERIOD

One-Time Initiative

Ongoing Campaign
USE OF FUNDS Describe in general how the grant funds will be used. Include estimated costs if known. (Note: Grants may be used to fund a portion of a project and are not limited to activities that can be funded in full. Worthwhile projects costing less than the anticipated grant amount will also receive full consideration, but will be funded at the project cost.)
Use of Funds
PUBLIC RELATIONS BUDGET Provide annual public relations expenditures for the following categories. Exclude overhead, benefits and the value of volunteer contributions.
PR Staff Compensation (if any)
Counseling Fees (if any)
Out-of-Pocket Expenses
We need to be matched with a PRSA / PRSA-LA member

Yes

No
PUBLIC RELATIONS PROFESSIONAL Provide the name(s) of the PRSA-LA member volunteer who will oversee your PR initiatives. Briefly describe their background or qualifications if you have history working with them.
PR Professional Info
FILE UPLOAD INFORMATION The upload fields below accept the following file types: PDF, DOC or DOCx and ZIP. To best preserve your formatting, PDF is recommended.
Articles of Incorporation
Internal Revenue Tax-Exempt Qualification Letter
Most recent annual report
TERMS AND CONDITIONS

If selected, the grant recipient hereby agrees to:
1. Use the funds specifically for the purposes outlined in this application under the direction of the professional named, or to notify PRSA-LA in writing prior to disbursement of any funds. PRSA reserves the right to request that grant proceeds be returned if the funds cannot be used for the specified purpose.
2. Cooperate with PRSA-LA to properly publicize the grant.
3. Provide PRSA-LA a final report on the program, including the results obtained and samples of materials produced which can be used to promote future grant applications.
4. Include proper credit in all applicable materials: “Made possible by a grant from the Don Perkins Community Service Fund, Public Relations Society of America, Los Angeles Area Chapter.”
5. Indemnify PRSA-LA, its officers and directors, from any legal liability related to the program(s) or material(s) produced through the proceeds of the grant, or related to the professional conduct of the designated practitioner, whether work on a paid or volunteer basis.
Applications must be approved by the executive director of the applicant organization and the public relations professional who will oversee the work.
Certification

Please check this box to certify that the information is valid and that BOTH the Executive Director and the PR professional have approved this application.