Program Grant

WHEEL SERVE NC

Program Grant
This grant is available for Wheel Serve NC programs. Wheelchair players are not eligible.
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 12/31/23
2023 Program Grant Cycle: 1/1/23 - 12/31/23.

Please email receipts to Kelly Flouhouse at kflouhouse@wheelservenc.com
Should be Empty:

WHEEL SERVE NC