HG Fund Request Form

HG Fund Request Form Please tell us how to reach you. First Name of Applicant: Last Name of Applicant: Email: Phone / Ext: Organization for consideration: Street address 1: Street address 2 (optional): City: State: Zip code: Please tell us how we can help. Amount for consideration: Purpose of donation / project description and benefit to community. List any other funding that is available:  Additional comments: In addition to completing this request form, the applicant must provide documentation of tax-exempt status under section 501(c)(3) of the Internal Revenue code and literature produced by the organization which describes the scope of its activities. You may provide these and any other supporting materials in the following ways: Email to: hwgfund2013@gmail.com Mail to: HG Fund, PO Box