City of Coppell TX - Application

Please contact Jesica Almendarez, Budget Officer, at Jesica.Almendarez@coppelltx.gov or (972) 462-5305 with 
questions. 
Special Interests First-Time Funding Application 
Date: 
Organization Name: 
Person Completing Information: 
At a Glance Summary 
Amount Requested (FY25/26):  
Narrative of Request/Scope of Service Provided: 
Explain Reason(s) for Funding Request: 
Explanation of Any Past/Current Funds Received from Coppell: 
Total Number of Individuals Receiving Service: 
Number of Coppell Residents Receiving Service: 
 
Percentage of Coppell Residents vs. Total Number Receiving Service: 
Total Operating Budget: 
Prior Year:
Current Year: 
Proposed: 
Dollar Value of Services Provided to Coppell Residents: 
Percentage of Operating Budget From Coppell: 
 
Overhead Percentage: 
Number of Persons in Organization: 
Employees: 
Volunteers: 
501.c.3/Non-Profit Number:

Please contact Jesica Almendarez, Budget Officer, at Jesica.Almendarez@coppelltx.gov or (972) 462-5305 with 
questions. 
Special Interests First-Time Funding Application (Page 2) 
The following three questions may require additional space or documentation.  Please submit that with 
the application in a standardized format. 
Please provide the organization’s mission statement and list the services, programs, and/or aid that 
directly benefits the citizens of Coppell. 
Describe the long-term financial plan for the organization as it relates to outside funding; specifically 
outline any fundraising, sustainability plans, or partnerships, including Coppell. 
Provide an anticipated time frame for the funding requests to increase, decrease, or cease as it relates 
to the organization’s long-term financial goals. 
Partner Cities/Agencies 
Amount 
Percentage of 
Funds Received 
Percentage of 
Svcs. Rendered 
To the best of my knowledge, the information submitted accurately reflects the financial status of the 
requesting organization. 
Signed: 
Name: 
Title: 
Date: