Emerging Needs Grant Application Form – Oshkosh Area United Way

Emerging Need Grant Application

Emerging Needs Grant Application

Organization Name *

Organization EIN/Tax ID Number *

Organization Address

City

State/Province

Zip/Postal

CEO/Executive Director Contact Information

First

Last

CEO Direct Phone Number

CEO Email Address *

Primary Contact for Application Information (If not the CEO.)

First

Last

Primary Contact Job Title

Primary Contact Phone Number

Primary Contact Email Address

If you are human, leave this field blank.