Central Standards Intake Form

Lead Applicant

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* Organization Name:

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* HQ Location:

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* Service Area:

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* Primary Contact:

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* Email:

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* Phone #:

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* Website:

Co-Applicant #1 (if applicable)

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* Organization Name:

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* HQ Location:

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* Service Area:

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* Primary Contact:

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* Email:

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* Phone #:

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* Website:

Co-Applicant #2 (if applicable)

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* Organization Name:

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* HQ Location:

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* Service Area:

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* Primary Contact:

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* Email:

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* Phone #:

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* Website:

Project Timeline

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* Please select the funding date that best aligns with when your project will be ready to begin

Option #1: Summer 2021

Option #2: Spring 2022

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* I agree that the Foundation may use my personal information to communicate with me about the Foundation and programs I may find interesting, to personalize my experience on Foundation web sites, conduct academic/charitable research, collect data about me from other sources, and share my data with trusted Foundation affiliates. Please review our privacy policy which provides info on how we use, process, and protect your data.

I agree to the privacy consent statement listed above