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Riverland Community Cares Grant Application
Applicant Contact Info
Applicant Name/Organization
Email
Phone
Address
City/Town
State
- Select -
Alabama
Alaska
American Samoa
Arizona
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Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
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California
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Federate States of Micronesia
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Is the organization exempt from payment of income tax?
Yes
No
If yes, a copy of an IRS letter indicating your organization's 501c3 may be asked for to verify.
If this individual or organization has previously received a Riverland Community Cares grant, provide the following information about the most recent grant received:
Date
Amount
What communities/counties are served by your organization?
Describe the specific project or purpose for which the funds will be used. Attach separate sheet if necessary.
Other revenue resources:
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