The Heiser Foundation Grant Request Form

THE HEISER FOUNDATION
GRANT REQUEST FOR AID
GRANT REQUEST TO ASSIST IN
FUNDING OF REQUESTS
THAT DIRECTLY REFLECT

Date

AMOUNT REQUESTED: $

ELIGIBILTY: Compliance with the Mission Statement of The Heiser Foundation. Please explain with a short (300 to 500 word) concise written description of event(s) that qualify under the Mission Statement. Please include all parties that will benefit from this grant. Feel free to add an additional page if necessary. Grants will be awarded on a priority basis at the discretion of the Foundation Directors quarterly.

Name

First Last

Organization Name (If Applicable):

Non-Profit Tax ID Number (If Applicable):

Address:

City:

State:

Zip Code:

Telephone:

Email:

Message:

The Heiser Foundation Grant Request Form

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