Name of applicant: _________________________ Age: ________
Applicant's phone and email: _______________________________
Signature: ______________________________
2. Please provide the name and Tax ID # of the co-sponsoring organization, the name and title of the adult agreeing to oversee the use of funds, and his/her phone number, email and signature.
Organization: ______________________ Tax ID # ______________________
Name/title of adult sponsor: _________________________________________
Signature: _________________________________________
Adult Sponsor's phone and email: ______________________________
3. Please provide a name for your project and the total amount requested.
Project name: _______________________________________________
Amount requested: ___________________________________________
Submit this form (may printed out and filled out by hand) along with:
* A 250-500 word simmary of your proposed service project and how you believe it meets community needs and the mission of AngelWorks.
* A requested grant amount and short summary of how funds would be used. (Money may NOT be used to pay students, but may cover costs for materials and other expenses associated with completing project.)
* A brief description of what evidence you will provide to show completion of project. This can include written and/or photographic material.
Mail to: AngelWorks c/o 4340 Janesville, Bel Aire, KS 67220