grant-form-2012-0727

Proforma Prana Donation Request

Proforma Prana is pleased to announce we are here to help our communities and this is our way of giving back. Each month we will give a worthy organization $250.00 in promotional products and/or services to spread the word, recruit volunteers, thank donors, or offer comfort to someone in need! If you are employed by, or serve on the Board of Directors of a non-profit group, religious organization, or school, and you are working to make a difference in your community, WE WANT TO HELP!

*Application is due min 2 months prior to your event;
*Donations are given every month;
*Winners must be a 501(c)3, School, or Religious organization;
*Organizations can only win once per year;
*We canonly grant one donation per year to a particular local organization/chapter/location;
*Maximum donation awarded is $250.00, if your donation request exceeds the max grant, you will be asked to pay the difference.

Thanks for all of your hard work in making this a better place to live!

Last Name

First Name

Organization Name

Street Address

City, State, Zip

Daytime Phone Number

###-###-#### - Please separate your phone number with HYPHENS ONLY.

Alt / Mobile Phone Number

###-###-#### - Please separate your phone number with HYPHENS ONLY.

Email

Confirm Email Address

Web Address

Organization Status

501(c)3 Regigious Organization Accredited school

Event Date

US Tax ID Number

XX-XXXXXXX

Has your organization applied for a donation from Proforma Prana in the past?

If yes, please click the approximate date of application.

Tell us about your organization.

Describe the population your organization serves. Please explain how many people you serve yearly and what type of services provided. **Max of 1,000 characters**

What product are you requesting and how would your organization use it?

Please tell us how this product will be utilized and distributed. Also tell how/why this product will benefit your organzation/event. **Max of 1,000 characters**

Why should your organization be chosen?

**Max of 1,000 characters**

Ver 2.1 - 2012-1030