Organization Information

Organization Name *

What's your organization called?

Organization Type *

Select the one that best fits

State & Region *

What state(s) are you in?

Point of Contact Name and Role *

Who should we contact? Include name and title/role

Population Served (if applicable)

Approximately how many people does your organization serve?

Are You in a Distressed Area? *

Yes - high unemployment

Yes - low income/poverty

Yes - disaster-affected area

Designated rural area

No, but planning for a specific region

Unsure

This helps us identify which programs you qualify for

Project Information

What Project Are You Trying to Fund? *

Describe your project in a few sentences. (e.g., "Regional broadband expansion for rural counties")

Project Cost / Funding Amount Needed *

What's the total project cost or the amount of federal funding you're seeking?

Project Timeline *

When do you need to have funding secured?

Project Type (Primary Focus) *

What's the main focus of your project?

If Multiple Project Types, Explain

If you selected "multiple types," briefly describe how they connect

Federal Grant Experience

Have You Pursued Federal Grants Before? *

This helps us tailor our recommendations

If Yes to Grants - What Programs?

If you've applied before, which federal programs? (e.g., EDA, FEMA, HUD, etc.)

Match Funding Capacity

Realistically, How Much Match Funding Could You Provide? *

This is important - many grants require matching funds

Potential Match Sources (Check All That Apply)

Local government budget

State funding sources

Private sector / corporate partnerships

Foundations / philanthropy

Community/economic development funds

Federal layered funding (other federal programs)

Honestly unsure

Where could you potentially find matching funds?

Constraints & Priorities

Any Industries or Sectors You're Targeting?

Leave blank if open

Geographic Flexibility *

Are you open to programs in other states?

Please Describe Geography if Applicable

E.g., "multi-county region covering 5 counties" or "tri-state area"

Any Programs or Funding You Want to AVOID?

E.g., "no disaster funding" or "avoid anything requiring complex audits"

What's Your Biggest Challenge Right Now?

Anything we should know? (E.g., "tight timeline," "limited staff," etc.)

Next Steps

How Would You Like to Receive Results? *

Email me the full written report

Schedule a brief call to discuss (I'll follow up to schedule)

Email report + optional follow-up call

All customers get a written report

Best Email to Reach You *

Where should we send your assessment?

Best Phone Number (Optional)

Optional - only if you want us to call to confirm details

Anything Else We Should Know?

Any other context that would help us research your opportunities?

✓ Thank You!

Your assessment request has been received.

We'll research your federal grant opportunities and send you a customized report within 2-3 business days.

Check your email: We'll send updates to the address you provided.

If you selected "schedule a call," we'll be in touch to confirm a time.

Federal Grant Assessment

✓ Thank You!