Community Contributions Application Form The application deadline for the 2019-2020 Community Contributions Program has passed. For consideration for the 2020-2021 program, please submit your information in the form below. Contact Us 1. General InformationOrganization Name*Address* Street Address City State / Province / Region ZIP / Postal Code Phone*FaxEmail* WebsiteName & Title of Contact Person*Address (If different from above organization address) Street Address City State / Province / Region ZIP / Postal Code PhoneFaxEmail* 2. About the OrganizationIs the organization?*A 501(c) 3 organization (non-profit)A local chapter of a national charityA vendor of Friendship Foundationnone of the aboveThe organization’s focus*Senior AdultsHealth and Human ServicesEducationArts and CultureOtherPlease note focusList any Friendship employees who volunteer for your organizationclick + button to right of input to add multiple names List your organization’s leadership team and board of directors along with their title and a brief description of that person’s role/involvement for your organization.*click + button to right of inputs to add multiplesNameTitleInvolvement 3. About the Requested ContributionDescribe the organization, program, or project for which you are requesting funding and how the community will benefit from it*Age group served (youth, seniors, etc.)Amount of annual budget*Percentage of contribution received going towards fundraising, marketing, and administrative costs*Type of request (monetary/in-kind/donated item)*Amount of request (if monetary)Value of request (if donated item/in-kind)Will Friendship Retirement Community be recognized for this donation*YesNoHow?Email address to send Friendship Foundation logo for publicity use* List any potential volunteer opportunities for Friendship's staff or residents through your organization, program, or project for which you are requesting funding.click + button to right of input to add multiples Name and date of event/programnamedate Date Format: MM slash DD slash YYYY Date by which funds/donated item needs to be received Date Format: MM slash DD slash YYYY 4. Financial InformationInclude a copy of 501(c) 3 classification from IRS, if applicable*Include evidence of financial stability in the form of balance sheets, income statements, and/or annual budgets of the organizations two (2) most recently completed fiscal years.*Projected budget for program or project, showing sources of funding & expenses* This iframe contains the logic required to handle Ajax powered Gravity Forms.