ELCIC/Eastern Synod Mission Grant Release Form

ELCIC/Eastern Synod Mission Grant Release Form
Organization Name (Congregation, Institution, Ministry Area, etc)*
Contact Person's Name

First NameLast Name
Organization's Mailing Address

Street Address

Street Address Line 2

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Postal / Zip Code
Phone Number
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Email
example@example.com
Registered Charity Number
On behalf of the above named organization, I agree that all funds given as an Eastern Synod Mission Grant shall:

1. be used soley for the use that was described in our project proposal, and

2. that our organization will submit a report outlining the use of these program funds by September 30 of the program year. Failure to submit a report by the posted deadline will require that grant funds be returned to the Synod Office.

***CHEQUES WILL NOT BE RELASED UNLESS A SIGNED COPY OF THIS FORM HAS BEEN FORWARDED TO THE SYNOD OFFICE.
Do you accept the terms of this grant as listed above?
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