Funding Requests
Individual making request:
Organization:
Amount Requested:
Date:
Phone:
Fax:
Email Address:
What groups/organizations will benefit from the contribution (youth, under privileged, arts, etc.)?:
Have any of the Stafford Companies funded this request before? No
Yes
If yes: Date Funded:
Amount Requested:
Amount Funded:
Other funding sources your organization utilizes:
Give a brief explanation/justification of why these funds are requested:
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