Hermanowski Family Foundation Initial Request Form

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Organization Name: Alice
Legal Name (if Different): John
Also Known As: John
Mailing Address: nduwzscq@dont-reply.me
City: Alice
State: TestUser
Postal Code: Alice
Main Phone: MyName
Main Fax: Hello
Organization Website: Alice
Employer ID Number: MyName
Organization Tax Status: John

Proposal Information

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Today’s Date: TestUser
Requested Amount: TestUser

Project Title: Hello
Project Description:

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Total Project Budget: Hello

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

Project Duration: Hello
Geographical Area Served: John
Age Group To Be Served: Alice

Contact Information

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Contact Prefix (Mr,Mrs etc.): TestUser
Contact First Name: John
Contact Last Name: Hello
Contact Title: TestUser
Contact Phone: John
Contact Email: nduwzscq@dont-reply.me