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Non-Profit Grant Application
Grant Information
Date:*
Organization Name:*
Tax-Exempt Organization to which Funds will be Distributed:if different from above
Organization or Pass-Through Agent`s Federal Id:*
Geographic Area This Project will Affect:
Description of the Project:*
Project Start Date:*
Project End Date:*
Amount Requested:*
Total Project Cost:*
Contact Information
E-Mail:*Valid e-mail is required
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
Marital Status:
Gender:
Date of Birth*
Phone:*
Budget Narrative
Please enter the description and cost of each budget line item below:
Professional Services/Labor:   
Travel:   
Supplies:   
Printing/Publications:   
Administrative:   
Meeting Space/Rental:   
Other:   
Grand Total:
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