Wallerstein Application Form

Wallerstein Grant Application

Below is the official application form for the Wallerstein grant. Please complete this form in its entirety to be considered. The criteria to obtain a grant is as follows: a woman-owned business or women's organization; business in existence no more than five years; completed grant application; support for women through activities and involvement in organizations that benefit women; and a copy of your business plan. WRT members and their relatives are welcome to apply, but will not receive special consideration. A written report will be required of the grantee within three months to verify how the funds were used. Should a grantee not comply with the terms of the grant, The Women's Roundtable has the right to request a refund of the specified funds within a reasonable time period. Prior grantees are ineligible.
  • Please include city, state, and zip code
  • Please include preferred number: home, work, or cellphone
  • MM/DD/YEAR
  • Please explain in the box below.