VENOCO COMMUNITY PARTNERSHIP GRANT APPLICATION
APPLICANT/GRANT INFORMATION
Organization: _______________________________________ Date: ___________________
Address: _______________________________________ Telephone: ___________________
  _______________________________________ Fax: ___________________
Tax ID No: __________________ Email:______________________ Website: _______________________________
Executive Director _____________________________________ Contact Person: ___________________
Signature  _________________________________________       Title  __________________________________
Purpose of the grant:  __________________________________________________________________________

Amount Requested: __________   Date Funds Needed: ____________   Total Annual Budget: _______________

Type of Request (check one that applies)
General  Program/Project  Capital/Endowment  Fundraising Event  Other________________


ORGANIZATION INFORMATION - maximum 2 page written proposal.
Briefly describe the mission and goal of your organization. Please include year of incorporation, current programs, activities, and accomplishments, geographic area served, number and type of individuals benefiting from services provided, and any additional information that would help us to better understand your organization.

GRANT INFORMATION – please describe the area for which you are seeking funding:
For general support, describe briefly how this grant would be used.
For endowment/capital support, briefly describe how funds will be used, how much is being raised, total amount raised to date, and who the major contributors are.
For program/project support, name of project, detailed description of the purpose, goals and outcomes expected, population served and how they benefit, other sources of funds, project timetable, itemized budget, and plan for evaluating the effectiveness of the project.
For fundraising event, briefly describe the function, how many people are expected to attend, list of sponsors, itemized budget for event, projected funds to be raised, and what these funds are to be used for.


REQUIRED ATTACHMENTS
List of Officers, Goverining Board and Major Donors
Most Recent Audited Financial Statements
Current Annual Budget
Proof of Tax Exempt Status


Please send completed application with required attachments to:

For Santa Barbara and Carpinteria:   For Denver and Houston:
Venoco Community Partnership
Attn: Marybeth Carty
Venoco, Inc
6267 Carpinteria Ave, Suite 100
Carpinteria, CA 93013
PH:  (805) 745-2100
FAX: (805) 745-1816
    Venoco Community Partnership
Attn: Bernadette Marquez
Venoco, Inc
370 17th Street, Suite 3900
Denver, CO 80202-1370
PH:  (303) 626-8311
FAX: (303) 626-8315

Applications will be deemed incomplete and will not be considered for funding until all required documentation is received