Friends of the Hatch Public Library Request for Funds
Date of request
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Month
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Day
Year
Date
Name of Organization
Name of Contact Person
First Name
Last Name
Email Address
Phone
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State/Zip
Zip Code
Total amount requested ($):
Provide a brief summary of your request, and describe how it aligns with the purpose of the Friends of the Hatch Public Library.
Date funds are needed
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Month
-
Day
Year
Date
If funded, do you agree to report back to the Friends of the Library on your project?
Yes
No
Signature
Submit
Should be Empty: