Grant Donation Application - Health Advantage Credit Union

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Health Advantage Cares Foundation Grant/Donation Request Application

Grant/Donation Requirements:

Funding requests must align with the Foundation's mission
Organization must be based within the Great Lakes Bay Region
Organization must be in good financial standing.
Organization is non-discriminatory for any reason, including race, religion, creed, age, sex, sexual orientation and/or national origin.

* Required Fields

Is your organization a 501c3 nonprofit organization?

If yes, attached 501c3 documentation:

Organization Name:

If organization goes by name other than legal name, please list it here:

Contact First Name:

Contact Last Name:

Contact Job Title & Department:

Contact Phone Number:

Extension # (if applicable):

Contact Email Address:

Organization Address:

Organization Address 2:

City:

State:

ZIP:

Organization County:

Organization Website:

Organization's Mission and Purpose:

What category best describes the organization?

How long has your organization been in operation?

What is the population served by your organization?

What is the geographic reach of your organization?

Has your organization received funds from the Health Advantage Cares Foundation in the past?

Yes

No

Amount Requested?

Provide a description of the project, program or event associated with your request:

Supporting Documents: Attach any relevant or supporting documents:

How would a donation from the Health Advantage Cares Foundation be used?

Impact Reach: How many individuals will be directly impacted by this donation?

If awarded funding, how will the Health Advantage Cares Foundations be acknowledged?

Funding Timeline: What date would your organization need the funds by?

Security Code:

Auto Loans

Credit Card

Mortgage Loans

Personal Loans

branches and atms

Branches & ATMs

Checking

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