1.How  would you describe your organization?

2.What services, if any, does your organization offer to pregnant females?

3.Does your Organization assist pregnant females with abortion or abortion-related services?

Yes

No

4.Would your organization be interested in applying for one-time grant funding to assist individuals facing unintended pregnancy with services aimed at encouraging them to give birth to their unborn children?

Yes

No

5.If your answer to Q4 is yes, briefly describe what the grant funds would be used for.

6.Are you familiar with completing a grant application?

Yes

No

7.Are you willing to attend a workshop via Zoom on how  to complete the grant application?

Yes

No

8.Any additional comments?