Download Forms Here…

Grant Request Form

Grant Request Forms with all the applicable attachments can be emailed to Katrina Mansfield at or mailed to Penn Treaty SSD, 702 N. 3rd Street, PMB 38, Philadelphia, PA 19123. If you would prefer to complete a word document version of the Grant or Event Sponsorship application, email Katrina Mansfield at and you will be supplied that version.

Please be advised that the PTSSD is only able to accommodate a maximum of three (3) grant requests per monthly meeting.  Requests are scheduled in the order in which they are received by the Administrator of the PTSSD Board. The PTSSD Board meets on the 3rd Wednesday of every month from 6:30-9:00pm EST  from September-June.
There are no meetings held in July or August.

Sponsorship Request Form

Event/Sponsorship requests will be voted on at the board meeting immediately following submission. Please allow at least one full month for turnaround prior to the event/sponsorship payment due date. There is a maximum of $5,000 issued per sponsorship request.

Grant Agreement Form

The Grant Agreement will be signed at the time your organization would receive your funds. It is available here for your advance review of the terms and conditions.

Progress Report Form

All grant recipients are required to complete an interim (6 months) and final report (1 year) after receipt of their grant. While the forms are provided at the time your organization would receive your grant, it can also be downloaded from the link above.

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