Program Grant

WHEEL SERVE NC

Program Grant
This is a reimbursement grant for Wheel Serve NC programs. Receipts required. Wheelchair players are not eligible to apply.
Date

MonthDayYear
Date
Program Location
Contact Person

First NameLast Name
Email
example@example.com
Check Payable To
Total Amount
$450 maximum
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Provide itemized list of expenses (max $450).
Funds provided through reimbursement until 12/31/24
Receipt Upload

Please provide receipt(s) to substantiate reimbursement.
Cancelof
2024 Program Grant Cycle: 1/1/24 - 12/31/24
Should be Empty:

WHEEL SERVE NC