Antioch Police Activities League (PAL)
Community Support / Funding Request Form
1. ORGANIZATION INFO
Name of nonprofit and 501(c)(3) number:
Main Contact Person:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
2. PROJECT/EVENT INFO
Name of Project/Event:
Date(s):
Location:
Brief Description (1-2 sentences):
3. FUNDING DETAILS
Amount Requested:
How will the funds be used?
4. COMMUNITY BENEFIT
Who will benefit? (Check all that apply)
Youth
Families
Schools
Community
Expected # of people served:
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Antioch Police Activities League (PAL)
Community Support / Funding Request Form
How does this support Antioch PAL's mission?
5. SIGN & SUBMIT
Name:
Title/Role:
Signature:
Date:
-
Month
-
Day
Year
Date
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Submit
Should be Empty: