OPERATION ROUND UP

Application

Operation Round Up Application

Applicant Organization

Organization Address

Contact Name

Contact Phone

Date

Project Title

Project Start Date

Project End Date

Total Project Cost

Grant Amount Requested

Would Partial Funding Be Acceptable?

Yes

Is Organization Requesting Funding Exempt From Payment of Income Tax?

Yes

If Yes, a Copy of Letter (Form 501[c]3) From Internal Revenue Service Must Be Attached

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Please Share Any Other Sources of Revenue