Application for Charitable Use of I AM WORTHY
For non-profit organizations seeking to qualify for complementary use of the I AM WORTHY curriculum 
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Name of Organization, Address, Website (if applicable) *
Are you officially recognized as a 501c3 organization, and are you willing to provide the supporting paperwork? *
Your first and last name and title/role *
Your phone number *
Your email *
What next generation age group does your organization serve? (Check all that apply) *
Required
What service(s) do you provide for children and/or students, and/or adults?  Please indicate how many children, students, and/or adults you currently serve.  *
How do you envision putting the I AM WORTHY video curriculum to use within your organization?  *
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