Online Application

Organization Name

Organization type Organization Type is required

501(c)(3) Tax Exempt Holder

Mailing Address Mailing Address is required

City City is required

State State is required

Zip Code Zip COde is required

City Of

Municipal Organization Name

SD # (Numerical only)

School Name

EIN

How did you hear about us?

Grant Project Grant Project is required

Project Location Project Location is required

County County is required

Brief description of what grant money would be used for (max 300 chars) Grant Description is required

Amount Requested from CHC

Amount Requested is required

Your Matching Funds

Matching Funds is required

Total (Request + Match)

Total is required

Project Contact Project Contact is required

Phone 1 Project Contact Phone 1 is required

Phone 2 Evening Phone is required

Email Address Email Address is required

Grant Writer Grant Writer is required

Phone 1 Grant Writer Phone 1 is required

Phone 2 Phone 1 is required

Email Email Address is required

Additional Project Contact Contact is required

Phone 1 Phone is required

Phone 2 Evening Phone is required

Email Email Address is required

Grant Application Grant Application is required