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United Way of Clallam County COVID-19 Crisis Fund Application
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Email
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Your email
Name of Organization
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Your answer
Please provide your EIN # (if not a United Way Partner Agency):
Your answer
Person Submitting Request:
*
Your answer
Agency Address:
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Your answer
Phone #:
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Website (if applicable)
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Today's Date:
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YYYY
Date Funding Needed By:
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YYYY
Request Amount: $
*
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Please state the nature of the request. How will United Way Funds be used?
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