COMPLETED GRANT APPLICATION WITH THE FOLLOWING INFORMATION INCLUDED: 1. COMPLETED W-9 2. IRS VERIFICATION OF 501(C)(3) TAX EXEMPT STATUS 3. FINANCIAL STATEMENT (AUDITED, IF AVAILABLE) OF THE AGENCY/ORGANIZATION 4. PROPOSED PROGRAM BUDGET 5. TOTAL AGENCY/ORGANIZATION BUDGET FOR THE CURRENT YEAR 6. LIST OF BOARD MEMBERS AND FULL-TIME/PART-TIME STAFF MEMBERS 7. DESCRIPTION OF THE ORGANIZATION, INCLUDNG A STATEMENT OF ITS INTENDED FOCUS 8. DESCRIPTION OF THE PROGRAM OR PROJECT FOR WHICH THE GRANT WILL BE USED, INCLUDING AN ILLUSTRATION OF HOW THE PROGRAM WILL BENEFIT THE ORGANZIATION, THOSE THE PROGRAM SERVES AND THE COMMUNITY

AWARDS ARE GENERALLY LIMITED TO USE IN THE COMMUNITIES SERVED BY THE HONESDALE NATIONAL BANK WITH A PREFERENCE TOWARD HEALTH AND HUMAN SERVICES, EDUCATION, CULTURE AND COMMUNITY ENHANCEMENTS.