Senior Services Inc.

Application for SSI project funding

 Please provide the information outlined in;

(A) Cover letter and project description as the initial step to initiate consideration for SSI to fund your project.

(B) Additional information that will be requested by SSI before funding is approved.

 A. Cover letter and project description
      Date of Application
      Full Legal Name of applying organization

      Project Name
      Amount Requested: $
      Total Project Cost: $
      Date funds are required from SSI

      Beginning and Ending Dates of the Project
      Write an executive summary narrative that includes
                     Description of the project.

                     Outcomes you plan to achieve
                     Who the project serves and why it is important.
                     Geographic Area to be Served

                     How the funds will be spent

                     Indicate how SSI will be recognized

                     What other organizations are involved, either by financial support or collaboration:

     Organizational information
                     Formal name
                     Year Founded

                     Executive director
                     Contact Person/Title


The letter should be signed by the board president or executive director.

 Send to:
                      Senior Services, Inc.
                    P.O. Box 18561, Fountain Hills, Arizona, 85269, U.S.A.
                    President, Lynn Strang,

 B. Additional information

      1. Verification of tax-exempt public charities status 
      2. Organizational structure listing officers and directors
      3. Financial statements, Prior year closing & Current year latest
                     a. Balance sheet
                     b. Income statement reflecting (source & use)  

                     c. Cash flow
                         Include all income, grant revenue & all general & project expenditures
       4. Sketches of project if applicable

       5.  A Report at the conclusion of the project.

       6.  Receipts may be required