Community and Cultural Donations – Tebughna Foundation

Community and Cultural Donations

Name of Event *

Date of Event *

Event Location *

Address Line 1

Address Line 2

City

State

Zip Code

Amount of Funds Requested ($) *

Recipient of donation *

Please designate individual or organization to make checks payable to.

Organization EIN (if applicable)

Point of Contact *

First

Last

Phone *

Email *

Recipient Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you directly related to a Tebughna Foundation board member? *

Yes
No

Please provide a brief description of the event/program the grant funds will be used for. *

Please provide a brief budget narrative that includes expenses and funds committed from other sources. *

File Upload

Click or drag files to this area to upload. You can upload up to 3 files.

Please attach any receipts, event/program agendas, photos, etc.

Signature *

Clear Signature