Junior Welfare Association :: Decatur, Illinois

APPLICATION FOR FUNDS
Name of Organization:
Contact Person:
Email:
Address 1:
Address 2:
City:
State:
Zip:
Phone Number:	Ext:
Fax Number:
Amount Applying For:
Date Funds Needed By:
Project Description:
Specific Use of Monies Received:
Number of People this donation will benefit.
Have you received any other donations for this program?	Yes No If yes, please explain in box provided below: