JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application for Funding from Refuse to Sink, Inc.
Non Profit Organization
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name of your Non-Profit Organization
*
Your answer
Address: Street or Post Office Box of organization
*
Your answer
City or Town
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone Number
*
Your answer
Contact Person Name
*
Your answer
Contact Person Title
*
Your answer
Email and phone number of contact
Your answer
Need to Email Credentials
Please indicate below that you are emailing a copy of letter Form 501c3 and latest previous year financial statement for your non profit to
a
bby@refusetosink.org.
Emailed copy of letter (Form 501 (c) 3) to
a
bby@refusetosink.org.
*
Choose
Yes
No
Emailed a copy of the most previous year financial statement
*
Choose
Yes
No
Number of individuals, families or groups served in Hendry, Glades, Highlands, Okeechobee or western Palm Beach County (South Bay, Belle Glade, Pahokee)
*
Your answer
State the purpose of your organization's request
*
Your answer
What is the total amount requested for this purpose.
*
Your answer
List the specifics of the project or need for which you are requesting funding.
*
Your answer
List a description of how the funds will be used for the specific project. Funding of budgets is not allowed. Only funding specific needs or project in line with Refuse to Sink's mission are eligible.
*
Your answer
List other sources of funding for the project you have described.
*
Your answer
How does your organization measure the effectiveness of its projects?
*
Your answer
Please provide the name, address and phone number for three business or financial references.
Your answer
Signature description
By typing your name, you certify that your are certified to sign for your organiztion and that the information in this statement is for obtaining funding from Refuse to Sink, Inc. on behalf of the undersigned. Each undersigned understands that the information provided herein is used in deciding to grant funding and each undersigned represents and warrants that the information provided is true and complete and that Refuse to Sink, Inc. may consider this statement to be true and correct until a written notice of change is provided. Refuse to Sink, Inc. is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.
Name of Organization
*
Your answer
Signature (Please type your name)
Your answer
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
