Caring for Community Application | Silver Star Internet Provider

Organization*

Contact Person*

Phone*

Email*

Mailing Address*

Street Address City State ZIP Code

Is your organization an IRS 501 (C) (3) not-for-profit?*

Organization Mission:*

Organization Budget:*

Percent of budget funded by contributions:*

Budget for program/project for which you are seeking funding:*

Amount of Request:*

Other sources of funding being sought for program/project:*

Project Description:*

Describe specific use of donation received:*

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