Non-Profit Giveaway Application

Non-Profit Name:

TIN/EIN:

Contact Name:

Contact Phone:

Contact Email:

Role with Organization:

Which best describes your Non-Profit?

Youth & Education (Schools, early childhood programs, after‑school programs, mentoring, and youth development organizations)

Community & Civic Organizations (Community improvement groups, service clubs, foundations, and culturally focused organizations)

Health & Human Services (Food shelves, housing assistance, mental health services, emergency support, and family services)

Arts, Culture & Recreation (Arts organizations, community theatre, music groups, museums, parks, and recreational programs)

Public Safety & Emergency Services (Volunteer fire departments, emergency responders, rescue squads, and disaster support organizations)

Economic & Community Development (Workforce development, local economic growth initiatives, and community stability programs)

Faith‑Based Organizations (Churches or faith‑based groups providing community services or outreach programs)

Other…

If awarded a $500 donation, how would your organization use the funds to support or strengthen the community you serve?

What does your organization love most about the community you serve?