GIRARD FOUNDATION



GRANT APPLICATION




Name of organization: ___________________________________________________________

Project/program name: ___________________________________________________________

Purpose of project/program: _____________________________________________________

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Amount requested: _______________________________________________________________

Project timeframe (start/end): __________________________________________________

Contact Person (Name/Title): ____________________________________________________

Address: ________________________________________________________________________

Phone number: ___________________________________________________________________

Fax: ____________________________________________________________________________

Email: __________________________________________________________________________

Signature of proposing officer:  ___________________________   Date: ____________