Giving back Charitable Organization Grant Application To apply, it is required that you fill out the form below. Name of Requesting Organization** Point of Contact/Person Making Request** Tax ID #* Legal AddressAddress (legal address)* City* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Email** Phone**Mailing Address & Attention to Info for Funds if DifferentAddress (mailing) City (mailing) StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code Is the institution qualified by the IRS under section 501c3?* Yes No If yes, please attach a scan in PDF format of the IRS determination letter.Max. file size: 50 MB.Please explain purpose of funds, how they will be used, nature of need.Please explain how request aligns with Juneberry Ridge’s mission: “nourish, educate, and build a better future”:If there is a deadline by which funds must be awarded, please indicate: Note: Award notifications are generally made in the month following each calendar quarter. We encourage applications be made with this information in mind.Are You Human?*Sorry, these ones are must-haves.PhoneThis field is for validation purposes and should be left unchanged.