Foundation Grant Application

Please provide as much information as you can to help our Board of Directors make their decision. Applications are reviewed quarterly, with submission deadlines as follows:

Quarter 1 – January 19
Quarter 2 – April 13
Quarter 3 – July 27
Quarter 4 – October 26

If you have any questions or need to request an emergency grant outside of the regular review cycle, please contact us at FlorenceCopperCommunityFoundation@FlorenceCopper.com.

Please note: If your organization received a grant in the most recent quarter, your application may be deferred to a future quarter for consideration.

Organization Name(Required)

Project Name

Organization's History

Organization's Goals

What services does this project or organization provide to the community?

Details about the Organization's Structure

Description of the Program Requesting the Grant

Description of Why There Is a Need

What specific activities will this grant help provide?

How will you evaluate the effectiveness of this program or initiative?

Other Information

Organization's or Project's Budget Information

Application Date

MM slash DD slash YYYY

Organization's Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

EIN(Required)

Organization's Phone Number(Required)

Organization's Website

Organization's Contact Person Information(Required)

First Last

Contact Person's Email(Required)

First

Mailing Address

Street Address City State / Province / Region ZIP / Postal Code

Contact Person's Title

Top Paid Staff Member's Contact Information (if applicable)

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Top Staff Person's Title

Is this organization a not-for-profit?(Required)

Is this a public agency?(Required)

Fiscal Agent EIN

Summary of Grant Request

Population Served

Geographic Area Served

Florence, Arizona

Pinal County, Arizona

Other

Interest Area

Education

Community and Economic Development

Health & Wellness

Cultural Heritage & the Arts

Other

Total Annual Budget of Organization

Amount of Funding Requested

Please add more information if needed about why you are requesting a specific amount and what the funds will be used for.

Is there anything else you would like our Foundation to know about your grant request?

In addition to the above form, you must submit Form 990 and your IRS letter of determination. Please send to FlorenceCopperCommunityFoundation@FlorenceCopper.com. Have you done so, or do you plan submit the forms in order to be considered?

Yes

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The technical information on this webpage is based upon the report entitled: “NI 43-101 Technical Report – Florence Copper Project, Pinal County, Arizona” issued March 30, 2023, with an effective date of March 15, 2023, which is available on SEDAR. The Florence Copper Project Technical Report was prepared under the supervision of Richard Tremblay, P.Eng., MBA; Richard Weymark, P.Eng., MBA; and Robert Rotzinger, P.Eng. Mr. Tremblay is employed by the Company as Chief Operating Officer, Mr. Weymark is Vice President Engineering, and Robert Rotzinger is Vice President Capital Projects. All three are Qualified Persons as defined by NI 43–101.

Foundation Grant Application

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