Charitable Requests $500 – $2,000
A meeting with the DTE Energy Foundation is not required prior to
submitting this application.
A. Application for 501(C)(3) Nonprofits
Please check one LEAD priority that best describes your request based
on information in “What We Support” on our website.
Leadership
Instructions:
Complete all fields. Save
a copy of the completed
application to your computer.
Email it and other required
documents as attachments to:
[email protected]
Please include your
organization’s entire name
and amount of funds you are
requesting in the subject line
of your email.
Education K-12
Education Higher Learning
Environment
Development
Example
Diversity
Exception (Our priority is to support programs/events that fit LEAD.
However, a few exceptions will be considered.)
Subject: ABC Nonprofit
grant request application
for $500.
B. Other Required Documents
1. Proof of organization’s nonprofit status: (501(C)(3) I.R.S. Letter
of Determination or print out from the GuideStar Website
at: (www.guidestar.org).
2. Tax or Employer Identification Number (this is listed on the 501(C)(3) I.R.S.
Letter of Determination or attach page one of the 990 tax form.)
A. Application for 501(C)(3) Nonprofits
$
Amount Requesting Application Date (xx/xx/xx)
Organization’s Legal Name
Year Established
$
Total Program Cost
Date of Last Audit (xx/xx/xxxx)
Organization Mission
Address (Principal/administrative office ) Suite, Building, Other
City
State
Phone Number (xxx-xxx-xxxx)
FAX Number (xxx-xxx-xxxx)
Zip
Website Address
Email Address
Phone Number (xxx-xxx-xxxx)
Email Address
Phone Number (xxx-xxx-xxxx)
Executive Director
Chief Development Officer
List all DTE Energy Employee(s) Affiliated with Your Organization/Request:
Name
Affiliation with Your Organization
Name
Program Name
Affiliation with Your Organization
Description of Program
Date(s) of Program
Geographic Area Served
Yes, my organization is currently requesting or has received cash and/or in-kind donations (includes, but not limited to, requests
for employee time, labor, company materials, tools, equipment, services or surplus goods), from an area of DTE Energy other than
the DTE Energy Foundation.
Please describe the donation(s) received, the amount, and source/contact person for the non-Foundation donation:
No, to the best of my knowledge, my organization has not received cash or in-kind donations from any area of DTE Energy in the
past two years.
Yes, my organization has received support from the DTE Energy Foundation in the past.
Signature of Applicant Making Request
Title
12-0389/11-12