Application for U.U.F.H. “Split-Plate" Collection
Please fill out and return to the B.O.W. Committee mailbox
Date :_________________
Names, Phone #s & Email Addresses of 3 Members recommending Split-Plate charity (one initiating member & two supporting members)
1.___________________________________________
2.___________________________________________
3.___________________________________________
Name of Organization:
________________________________________________________________________
Goals of the Organization:
______________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________
Organization’s History/Mission Statement(Attach additional pages if needed)
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Need for Funding at this time:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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