Hemlock Semiconductor Youth Grant Program Application
Fiduciary Organization Name
This should be the formal name of the Organization holding the Tax ID number you are using (i.e., "Midland Public Schools" vs "DHHS Varsity Softball"
Tax Id Number
Team / Group Name
Here's where you specify group, such as, "MHS Drama Club"
In which county does your youth group operate?
HSC Sponsor Name
HSC Sponsor E-mail
Main Contact Name
Main Contact E-mail
Main Contact Phone Number
Please enter a valid phone number.
Youth Group Address
Street Address Line 2
State / Province
Postal / Zip Code
Please describe your organization and team
What is your mission? Why do you do what you do?
Statement of Need
For what will the grant funds be used? What factors contribute to the need? Why is it important to the group?
Proposed Not-For-Profit Organization to benefit
Physical location of proposed Volunteer Activity
If not self-evident by Organization name
Proposed Volunteer Activity Description
This should be planned and coordinated with the Beneficiary Organization Contact before your application
Proposed Number of K-12 Youth participating
Estimated number of K-12 Volunteer Hours
Estimated of Adult Mentors Participating
(Adult participation is not included in Evaluation process)
Should be Empty: