Terry-Len GRANT APPLICATION
Contact Information
Business Name
Website
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization President / Executive Director
First Name
Last Name
Title
Phone Number
Please enter a valid phone number.
E-Mail Address
example@example.com
Contact Person
First Name
Last Name
Title
Phone Number
Please enter a valid phone number.
E-Mail Address
example@example.com
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Organization Information
501(c)(3)?
Yes
No
Year Established
Is the Business Incorperated
EIN
Do you have Business Banking account
Total # of Board Members
Total # of Staff
Total # of Volunteers
Business Mission Statements
Brief Description of Organization
What are the biggest challenges your business is currently facing? What opportunities do you see for growth and expansion?
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How will this grant help you achieve your business goals?Describe the specific ways in which the grant funds will be utilized to benefit your business?
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