Grant Application: Organization

Grant Application: Organization
Name of organization:
Name of contact person

First NameLast Name
Email of contact person
example@example.com
Phone Number of contact person
Please enter a valid phone number.
Website of organization
Facebook page of organization
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tax exempt number
Year tax exempt status was granted
Name of horse(s)
Amount requested
Number of equines currently in rescue
Monthly rescue expense
Monthly rescue income
Income source(s)
Are you actively fundraising for this purpose?
If yes, amount raised to date?
Vet reference name
Vet reference email
example@example.com
Vet reference phone
Please enter a valid phone number.
Vet reference address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Farrier reference name

First NameLast Name
Farrier reference email
example@example.com
Farrier reference phone number
Please enter a valid phone number.
Signature

Clear
Date

MonthDayYear
Date
Please forward the last 2 years of 990s as well as a current bank statement to Beechbrookfarm@yahoo.com Once received, your application will be processed. Please inform your references that they will be contacted
Should be Empty: