Funding is available for agencies in our area who are providing COVID-19 relief. You must have JavaScript enabled to use this form. Organization Name Tax I.D. or EIN# Phone Number Street Address City State Zip Code Our Organization is a: (select one) - Select -501(c)(3) nonprofit organization Fiscally sponsored by a 501(c)(3) organization School or other public entity (able to receive tax-deductible donations) First Name Last Name Contact Email Contact Phone Has your organization applied for and/or received COVID-19 relief funding from any other sources? - Select -Yes No Please list source, amount requested, and status of request Number of people this funding will serve? Anticipated length of time the funds will cover? Please briefly explain how your organization is working to meet the basic needs of those most significantly impacted by COVID-19 (250 words or less)? How has the current situation impacted your budget? Amount of your funding request: If awarded, how will the funds be utilized? Submit Leave this field blank
