2023 Make a Difference Day Community Partner Grant Proposal Form Make a Difference Day Grant Information Organization/School's Name Please Provide Company/School Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Contact Person Information Name Email Phone Tell Us About The Community Service Need You Have Identified. Which category does this need fall into? (Preference will be given to projects that fall into United Way's vision of Education, Basic Needs, and Health) Education Basic Needs Health Have you applied for any other grants or volunteer requests for this project? (e.g. Be the Church, Operation Round Up, etc) Yes No Other… Enter other… Short Description of Volunteer Activity: Total Amount Requested: Please provide a budget for your total project designating the funding you are requesting, a description of the supplies, and the vendor. Total Number of Volunteers Needed: A brief list of project tasks that volunteers need to complete on Make a Difference Day. Do you need a skilled or expertise volunteer to assist with any preparation of the project? This could be through knowledge or labor. If so, please describe in detail your needs. Yes No Please Describe. Enter other… Do you need any special equipment to complete the project? Please describe. Yes No Please Describe. Enter other… What is the expected long-term impact of this project on the community? Date of Project: Friday, October 27, 2023 Saturday, October 28, 2023 Both Days Other (please specify) Enter other… Approximate Time(s) of Project(s). Location of Project. Location of the project with physical address. Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
