Hermanowski Family Foundation Initial Request Form

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Organization Name: Children’s Day Preschool
Legal Name (if Different): Children’s Day Preschool and Family Center
Also Known As: CDP
Mailing Address: 104 Jefferson Street
City: Passaic
State: NJ
Postal Code: 07055
Main Phone: 973-777-5544
Main Fax:
Organization Website: www.cdnfc.com
Employer ID Number: 22-149-315
Organization Tax Status: 501

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: