Request Funding & Support — GLG Association

Organization Information

Organization Name *

Contact Person *

Title

Phone *

Email *

Website

Organization Address

Type of Support Requested *

Select all that apply.

Amount Requested

$

Please briefly describe your organization and the purpose of this request. *

0 / 3,000 (minimum 100)

Who will benefit from this support and how? *

0 / 3,000 (minimum 100)

Date Support Needed By

Program/Event Name

Program/Event Date

Accepted: PDF, DOC, DOCX, XLS, XLSX, JPG, PNG. Max 25 MB per file.

Documents you're including (checklist)

I certify that the information provided is accurate and complete.

Electronic Signature (type your name) *

Printed Name *

Date