Friends of the Hatch Public Library Request for Funds
Date of request
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Organization
Name of Contact Person
First Name
Last Name
Email Address
Phone
-
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
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit 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: