Please print this form and mail or fax it to the

Arthur Jordan Foundation 

fax (317) 632-5488



Proposal Cover Sheet



Organization Name ___________________________________Tax ID # ________________


Address ___________________________________________


City _______________________  State _________ Zip Code __________


Contact ___________________________________________        Title ___________________


Phone _________________________                                   Fax ____________________


Organization's purpose





Project summary (if applicable)






Funding type


______  Operating support


______  Capital support


______  Special Project Support



Amount requested ___________________ Percent of Total Appeal _________________



Attachment checklist


______  Cover letter describing organization


______  IRS Tax Exemption Letter


______  List of Board of Directors and Officers


______  Current budget (and project budget if applying for a special project)


______  Balance sheet and Income and Expense statement (audited statements are welcome)


Requests should be mailed or delivered by March 1 to:


            Arthur Jordan Foundation

            1230 N. Delaware Street

            Indianapolis, IN  46202