School/Organization Request Form

School/Organization Request Form

We would love to see your church begin or grow a special needs ministry. Tell us a little bit about your church and what your needs are.
Organization Contact Person*

First NameLast Name
Organization*
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What project are you requesting funding for?*
How will your project improve the lives of those living with a disability?*
Is this a one time request or ongoing?*
What other funding sources have you investigated/obtained?*
Is there anything else we should know?*
Should be Empty: