Iowa-Nebraska NAACP COVID: KNOW MORE Grant Agreement Faith & Non-profit Organizations

Iowa-Nebraska NAACP COVID: KNOW MORE

Grant Agreement
Date

MonthDayYear
Date
Representative*

First NameLast Name
Address*

Business Name

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Facebook Name
Instagram or Twitter Name
AGREEMENT

By signing, I agree on behalf of my organization to adhere to the grant timeline, statement of scope and conditions as provided by the NAACP. I will complete the W9 form and email it to IowaNebraskaNAACP@gmail.com in order to receive payment.

STATEMENT OF SCOPE: The Grantee’s primary role will be to share and distribute materials provided by the Iowa-Nebraska NAACP about COVID-19 and the importance of vaccinations to customers, clients and community members in their area. The Grantee serves as a reliable information source and will share factual information provided by the NAACP about receiving vaccinations, where to receive a vaccination and how to encourage community member to get vaccinated.

The Grantee will receive a vaccination educational kit containing a poster to hang in their place of business, information sheets with a QR code linked to additional resources, hand sanitizer, and masks. These resources will be provided by the Iowa-Nebraska National Association for the Advancement of Colored People (NAACP).
Verify by providing the last 4 digits of your social security number.*
Signature: Use your mouse*

Clear
Thank you!
Should be Empty: