Request Grant Application | Pink House Foundation

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Request Grant Application

Please fill out this form and submit to the Pink House Foundation no later than June 1, 2013. (change from previous date.)

Once we determine your grant eligibility, we will send you the (longer) Grant Application Form to complete. Completed Grant Application Forms will be due no later than July 1, 2013. Chosen grants will be funded in late 2011.

Pink House Foundation Statement of Interest
Please respond to all of the questions in the space provided. You may attach additional written information for any question which does not provide adequate space to answer.

Date
MM
DD
YYYY
Name of Applicant
FirstLast
Email
Address of Applicant
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Person to be contacted
FirstLast
Phone
Is Applicant a charitable trust?
Yes
No
Is Applicant a nonprofit corporation?
Yes
No
Is Applicant an unincorporated association?
Yes
No
Is Applicant an individual?
Yes
No
Is Applicant a qualified 501(c)(3) organization?
Yes
No
Please describe the projects to be funded, why they are important, and the amount requested (no more than $5,000) for each project (using attachments or additional pages, if necessary:
How will you measure the success of this project?

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