EmailMeForm
Full Legal Organization Name
*
Address
*
City/Zip Code
*
Organization Website Address
*
Organization President/Executive Director
*
Phone
Email
*
Contact Person
(if different from above)
Title
*
Phone
*
Email
*
Year Established
*
501(c)(3)?
*
Yes
No
Please send copy of Tax Exemption to ebrown@nnoac.com
Total Number of Members
I understand - Must include copy of IRS Tax Exempt Letter
*
Yes
How will the grant money be used by your organization?
*
How many officers/first responders will benefit from this grant?
*
Amount Requested
*
