City of Beverly
Grant Application Approval Form
Pleasesubmitthisform(alongwiththegrantapplication)totheDirectorofGrantspriortoapplyingforagrant.TheDirector
ofGrantswillobtainapplicationsignaturesfromtheMayorifrequired.ForquestionspleasecontactCatherineBarrettat
978‐605‐2368orcbarrett@beverlyma.gov.
_____________________________________________________________________________________________
DateSubmittedforReview/MayorSignature: DateResponseRequired:
GrantTitle:
GrantSource(Fed,State,Foundation,CorporateGiving):
Department/OrganizationApplying:
ContactPerson:
ContactPhone#/Email:

GrantPurpose

GrantAmount(Indollars):
 CostReimbursable(Y/N):
MatchRequired(Y/N): Amountofmatch(Indollars): ___
Howwillthematchbefunded(fundcode/inkind):___
GrantPeriod: ___GrantNotificationDate:_____________________
Internal/ExternalPartners:______
Notes:_________________________________________________________________________
GrantStanding(Pleasecheckone):
___Grantisnewtothisdepartment
___Grantisarenewal/continuationofanexistinggrantheldbythisdepartment
SignatureofDepartmentHead/Designee:
SignatureofDirectorofGrants:
SignatureofMayor:_______________________________________________________
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