Grant – Application Grant – Application – GC Organization Information Name of Organization * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Federal Tax ID# * IRS 501(c)(3) Status [NOTE: Organizations receiving funding are required to submit their IRS determination letter.] * I attest that this organization has been designated 501(c)(3) status by the IRS and understand that a copy of the official designation will be required to accept any awarded funds Contact Information CEO/Exec. Director * Email * Program Contact Person * Program Contact Email * Program Contact Phone * If you are human, leave this field blank. Next Save Draft Δ
