Grant Application

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Organization Details

Name of Organization *

Legal Name (if different)

Address *

City *

State *

Zip Code *

EIN (Employer ID) *

Phone *

Fax

Website

501(c)(3) Determination Letter *

Operating Budget *

IRS 990 Form *

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Contact Details

Contact Name *

Contact Title *

Contact Email *

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Grant Request Details

Grant Request

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Project Description

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Will your organization accept partial funding for this project? *

Yes

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Check Yes to confirm the CEO or Executive Director has reviewed and approved the submission of this grant application. *

Yes

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* Indicates a Required Field