Hermanowski Family Foundation Initial Request Form

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Organization Name: xttlurujgm
Legal Name (if Different): yigzunwlqs
Also Known As: gsdqdompjp
Mailing Address: oyszrxth@checkyourform.xyz
City: kjvlqdxdkq
State: wgtmguelgw
Postal Code: kyeetepiso
Main Phone: +1-724-752-0852
Main Fax: rvdhuiuvje
Organization Website: ytfmvopgey
Employer ID Number: jgyrjnorxg
Organization Tax Status: fygmvrnuev

Proposal Information

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Today’s Date: islemjrmns
Requested Amount: idykipdrrf

Project Title: sxgyjgkkgu
Project Description:

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Total Project Budget: zndwnoihzm

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

Project Duration: utltzqyplj
Geographical Area Served: epfgikgmod
Age Group To Be Served: mspesizhfq

Contact Information

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Contact Prefix (Mr,Mrs etc.): gpomyhizwl
Contact First Name: xfnifvdwmf
Contact Last Name: wmywvmhyup
Contact Title: gggpqumndj
Contact Phone: +1-724-752-0852
Contact Email: oyszrxth@checkyourform.xyz