Hermanowski Family Foundation Initial Request Form

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Organization Name: Dallas Hope Charities
Legal Name (if Different):
Also Known As:
Mailing Address: PO Box 196006
City: Dallas
State: TX
Postal Code: 75219
Main Phone: 6308639635
Main Fax:
Organization Website: www.dallashopecharities.org
Employer ID Number: 81-2568424
Organization Tax Status: 501(c)(3) nonprofit

Proposal Information

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Today’s Date:
Requested Amount:

Project Title:
Project Description:

Total Project Budget:

Other Funding
Sources For The Project (Committed & Potential):

Project Duration:
Geographical Area Served:
Age Group To Be Served:

Contact Information

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Contact Prefix (Mr,Mrs etc.):
Contact First Name:
Contact Last Name:
Contact Title:
Contact Phone:
Contact Email: