First Responder Grant Application

First Responder Grant Application

The RWA's First Responder Grant Program provides financial assistance to fire and emergency service organizations that operate within our service territory. The maximum grant amount is $2,000. Direct any questions to Kevin Watsey.

Organization Name*

Uniformed volunteer fire departments and emergency service agencies serving the RWA's service territory are eligible for grants. No grants will be awarded to individuals.

Organization Website

(You may leave this blank if no website exists.)

Organization Mailing Address*

Organization Physical Address

(Leave blank if same as mailing address.)

Contact Name*

Whom should we contact about this grant application?

Contact Phone Number*

Phone

Contact Email*

Organization Type*

Please specify if this organization is volunteer, professional or combined.

Volunteer

Professional

Combined Volunteer/Professional

# Volunteer Members*

How many members of your organization are volunteers?

# Professional Members*

How many members of your organization are paid professionals?

Grant Amount Requested*

Provide a specific dollar figure for your grant request.

Items to Purchase*

List all items or services you intend to purchase with this grant.

Grant Justification*

Why do you need the items or services you intend to purchase with this grant?

Intended Use*

How will the equipment or services purchased with this grant be used by the organization?

Will Additional Funding Be Needed?*

Will this grant fulfill the financial needs of your request/project, or will you need additional sources of funding?

Select

Additional Funding Sources*

If you answered "No" to the question above, have you identified the source(s) of additional funds? Please specify. (Respond "N/A" if no additional funding is required.)

Supporting Documents*

Please use the space below to attach:

manufacturer's cut sheets or quotes to support your grant request; and,
a copy of your W-9 Tax ID form.

Drag and drop files here or

Send me a copy of my responses

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