Goldeyes Field of Dreams Foundation Funding Request Form
Contact Info
Official Name of Charity
*
Charity Number
*
15 digit number required
Are you a Charity within Manitoba?
*
Yes
No
Are you requesting funds for Manitoba residents?
*
Yes
No
Are you requesting funds for Manitoba recipients under the age of 18?
*
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name
*
First Name
Last Name
Title:
Email
*
Phone Number
*
Charity Background
Charity Description (500 characters or less):
*
0/500
Who benefits from your charity? (200 characters or less):
*
0/200
Funding Requests
Funding Request #1 (200 characters or less):
*
0/200
Amount Requested:
*
Funding Request #2 (200 characters or less):
0/200
Amount Requested:
Funding Request #3 (200 characters or less):
0/200
Amount Requested:
Submit
Should be Empty: