Hattie A. & Fred C. Lynam Trust

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Cover Letter:
Include a basic one-page cover letter providing a brief description of the project and stating the requested amount.

Part 1: Grant Request Form
Fill out and submit the grant request form online.

Part 2: Proposal Attachments
Attach copies of the following:
• Most recent financial statement (audited if available)
• Current/final 501 (c) (3) IRS determination letter
• A list of the current board members including their employment
and/or community affiliations
• A list of the current staff members
• Project budget

When applying online, you may email your cover letter and proposal attachments to Julie Zimmerman at jzimmerman@bhbt.comm. Please specify your organization's name along with "Lynam Foundation Grant Request" in the subject line. PDF or Microsoft Word documents are preferred.

Materials may also be submitted by mail to:
Julie Zimmerman,Trust Officer
Bar Harbor Trust Services
P.O. Box 1100
Ellsworth, ME 04605

GENERAL INFORMATION
*Date of Application:		A value is required.Invalid format.
*Name of Organization:		A value is required.
*Year of Establishment:		A value is required.
*Address:		A value is required.
*City:		A value is required.
*State:		Please select an item.
*Zip Code:		A value is required.Invalid format.
*Telephone Number:		A value is required.
Fax Number:
Web Address:		Invalid format.

*Is your organization tax-exempt under 501 (c) (3)?		Yes No Please make a selection.
Year Incorporated (if applicable):


*Type of Request (choose one):		Capital Campaign Operating Support Project/Program Request Other Please make a selection.
If other, please specify:


	If requesting operating support, enter the organization’s current budget. For all other requests enter the specific project budget.

*Amount Requested:		A value is required.
*Total Operating Budget:		A value is required.


*Purpose of the Request:		A value is required.


CONTACT INFORMATION
*Name of Contact Person:		A value is required.
*Title:		A value is required.
*Email:		A value is required.Invalid format.
*Telephone Number:		A value is required. Ext.

ORGANIZATIONAL BACKGROUND
*History/Background:

*Mission/Current Programs:

*Geographic Area(s) Served:

	* Required field

	APPLICATION AUTHORIZATION AND ASSURANCES Please make a selection.The applicant hereby attests that: The information contained in this application is true and correct to the best of my knowledge.

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