Charitable Donation Application Request

Welcome to the Moody Cares Charitable Donation Request. In order to have your request reviewed, you must complete the entire application. Applications can be submitted throughout the year.

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* 1. Organization Name

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* 2. Physical Address

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* 3. Mailing Address

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* 4. Phone Number

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* 5. General Email

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* 6. Organization Website

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* 7. Tax ID Number

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* 8. Executive Director Name

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* 9. Executive Director Phone

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* 10. Executive Director Email

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* 11. Direct Contact Name

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* 12. Direct Contact Phone

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* 13. Direct Contact Email

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* 14. What is the mission of your organization?

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* 15. Organization Type

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* 16. Population Benefited

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* 17. Age Group Benefitted

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* 18. Gender Served

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* 19. How many clients did your organization serve in the last fiscal year?

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* 20. What is the percentage of the clients that are low to moderate income (LMI)?

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* 21. What geographic areas do you serve? Select all that apply.

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* 22. Request Summary

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* 23. Request/Project Title

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* 24. Request Summary

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* 25. History of the organization

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* 26. What are your expected outcomes for the project?

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* 27. Provide any details about partnerships and collaborations the project or organization currently has.

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* 28. What is the expected timeline for the program or project?

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* 29. What is the project budget total?

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* 30. What are other sources of funding for the project?

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* 31. Does your organization have volunteer opporutnities for Moody Bank employees?

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* 32. If so, who is the primary contact for volunteers?

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* 33. Volunteer Email

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* 34. Volunteer Phone

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* 35. I certify the that the information contained in this sponsorship application is true and correct to the best of my knowledge.

Thank you for completing the Moody Cares Charitable Donation Application. You will be notified in 6 to 8 weeks via email on the status of your application.

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