GRANT APPLICATION FOR SUPPORT OF LOCAL HUNGER AGENCY
Local Agency Name
Street
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
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ND
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OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Phone
Email
Contact First Name
Contact Last Name
Does this agency have Federal IRS tax-exempt status as a 501(c)(3) organization?
Yes
No
If the local agency is NOT tax-exempt with the IRS, it will be necessary to have a local church or other tax-exempt entity assume responsibility for the grant funds.
If a copy of the 501(c)(3) form has not been previously filed with Church World Service, please upload a copy here.
Do NOT upload your State Sales Tax Exemption Number.
Pass-Thru Agency Name
Street
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Phone
Email
Contact First Name
Contact Last Name
If a copy of the 501(c)(3) form has not been previously filed with Church World Service, please upload a copy here.
Do NOT upload your State Sales Tax Exemption Number.
Is the project ecumenically sponsored or approved
Yes
No
Describe in detail how the grant will be used:
How will the receiving agency assist in organizing the CROP Hunger Walk event?
Requested percent of funds raised through the CWS/CROP Hunger Walk event:
Please enter the number only, such as "5" or "10" to ndicate the percentage.
CROP Hunger Walk Name
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
CWS Staff Contact
Please select...
Adam Smedberg
Amir Khan
Andrew Gifford
Belinda Addae
Erin Luchenbill
Heather Willson
Kevin McCoy
Leonard Blue
Nick Gliha
Rachel Kessel
Roberta Macauley
My staff contact is not listed
I do not know
Signature (full name of the person completing this application)
Contact Information