Governor's Grants Program

In order to apply for grants, organizations will need to register with the Governor's Grants Program Grant Portal. The portal will provide a login and password to the contact listed below via e-mail. No more than one login will be provided for any organization. Be sure to keep the login and password in a safe and accessible place. The Authorized Certifying Official for the organization will be considered the primary contact and the access administrator.

Indicates required information

Organization Information

Agency Name:
FEIN:
Street Address:
		optional
City:
State:
Zip Code:
County:
Phone:
Fax:		optional
Website:		optional

Please check one of the following that best describes your organization:

	501(c)(3) Non-Profit		Government-Municipal
	Government-State		Government-School District
	Government-University		Government-Tribal
	Government-County		Other

Please check one of the following that best describes your organization:

	Law Enforcement		Hospital
	Prosecution		Children's Services
	Court		Domestic Violence Services
	Corrections		Sexual Assault Services
	Education Center		Elderly Services
	Mental Health		Faith-Based Organizations
	Substance Abuse Services		PSAP
	Native American Tribe or Organization		Other

As the Authorized Certifying Official, I hereby authorize the Governor's Federal & Other Grants Program to issue our organization a login and password that will serve as my electronic approval/signature for the eGrant system. I understand that I am responsible for who has access to this login information. I will provide a letter authorizing any additional individual(s) to use this account.

Authorized Certifying Official

Name:		This will serve as your electronic signature.
Title:
E-mail address:

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Governor's Grants Program Grant Portal

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