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MEMBER APPLICATON

Small Grant Application

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W9

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Mission Statement

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Activity Start Date * required

Activity End Date if Applicable

How many people do you expect to be impacted or reached?

Activity Information

Marketing Activity

What is the total cost of the activity?

What is the amount of money requested?

Utilization of Funds

Can the activity proceed with partial funding?

Project budget, please show how each of the funding categories will be used:

Signature Date * required

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BECOME A MEMBER

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