Casella Grant Application

Casella Grant Application

Organization Name *

Your organization’s federal taxpayer ID number Format 12-1234567

First Name *

Last Name *

Email *

Phone

Mailing Address *

City *

Zip *

Physical Address if Different from Mailing Address

City *

Zip *

Describe Your Organization, Event, or Project

What are you requesting? *

Cash Donation
In-Kind Service Donation
Sponsorship
Volunteers
Other (Please Describe)

Other: Please describe

What is the amount you are requesting? *

Other Description *

Is this funding specific to an event or project? *

Yes
No

If yes, what is the date of the event or project? *

Describe the event or project and how the proceeds will be used: *

Please attach the following: • Any additional information to support your request • Copy of tax-exempt notification letter from IRS or equivalent documentation *

Any additional notes/comments?

Consent for storing submitted data *

Yes, I give permission to store and process my data