Zimmer Community Fund Grass Roots Grants Application Please remember to email a few photos of your program at work. Follow up with us in a week to check on your application’s status. Application form Subscribe Nonprofit NameFEIN #Name of Person Completing This ApplicationTitleMailing AddressAddress Line 1Address Line 2CityStateZip CodePhysical Address (if different from mailing)Address Line 1Address Line 2CityStateZip CodePhoneEmailWebsiteDate of Last NM-COROS FilingDate of Last US-990# Paid Employees# Years in OperationMission StatementService DescriptionService AreaHow Did You Hear Of Us?Have you received a grant before? Yes NoIf yes, how did you use the grant?Date RequestedAnnual Amount RequestedHow do you intend to use the grant?Executive Director Signature (Digital)Submit Form