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* 1. Organization Name

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* 2. Mailing Address

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* 3. Point of Contact Name, Title and Email Address

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* 4. Phone Number

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* 5. Please state your organization's mission and vision. What were your 2020 challenges and how did you overcome them?

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* 6. Does your organization's mission specifically focus on serving any of the following populations?

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* 7. Statement of Need

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* 8. How will you decide to distribute the 20 gifts-card?

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