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    As an advisor to the

    (your fund name)

    Fund,

    fund code (optional)

    I (we) recommend the following grant(s) of $500 or more for:

    Organization:

    Contact Person Name & Title:

    Address:

    City:

    State:

    Zip:

    Email:

    Phone:

    Amount:

    $

    Frequency:

    ($

    per month)

    Purpose of Grant:

    (e.g., general operations, capital campaign, specific program, endowment, etc.)

    I Wish to Remain Anonymous:

    For another grant recommendation, please make another submission.

    The distribution(s) suggested above are advisory only and do not represent satisfaction or discharge of any pledge or other financial obligation.
    In addition, the distribution(s) will not result in any personal benefit to the undersigned, such as a membership, tickets to events, etc.

    Advisor's signature

    Date

    Additional Advisor's signature

    Date