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Action Grant Application
Action Grant Application
Organization/Individual's Name
(Required)
Mission Statement:
(Required)
Project Goal:
(Required)
Amount of this request:
(Required)
Total cost of project:
(Required)
Project Description:
(Required)
Project Start Date
(Required)
MM slash DD slash YYYY
Project End Date
(Required)
MM slash DD slash YYYY
Contingency Plan
(Required)
If full funding is not received, what is your contingency plan for your project?
Examples of Past Projects
(Required)
Drop files here or
Select files
Max. file size: 300 MB, Max. files: 3.
Attach one of the following: resume, Board of Directors list, or letter of support from community/organization leader
(Required)
Max. file size: 300 MB.
Name of authorizing official
(Required)
First
Last
Phone
(Required)
Email
(Required)
Mailing Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Certification
(Required)
I certify that the information contained in this application, including all attachments and supporting materials, is true and correct to the best of my knowledge.
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