Grant Application

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Name

First

Last

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SSN

Payment Project and/or

Date of Birth

Phone Number

Address to Mail Grant Payment If Approved

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Grant Proposal

Please provide information about the project for which you are seeking a Grant.

Category

Amount Requested

Anticipated Start Date

Estimated Completion Date

Project Name

Please Describe the Project Objectives.

How Will the Project Benefit the Community and/or Improve the Lives of Those in Need?

Please Upload Your Valid ID Here (Front)

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Please Upload Your Valid ID Here (Back)

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By submitting this form, I certify that the information provided is accurate and complete to the best of my knowledge. I understand that submission does not guarantee funding and that any false or misleading information may result in disqualification. I agree to Grant Aid’s Terms of Use and Privacy Policy.

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Date

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