Waynesboro Beneficial Fund Grant Application

Please complete the form below to submit your application for a grant request.

Organization Name

Tax ID & Nonprofit Status

Amount Requested

Number of People Served

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Phone

(###)

###

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Business Fax

(###)

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Point of Contact Name

First Name

Last Name

Point of Contact Email

Organization’s Mission Statement:

Summary of Donation Request (How the funds will be used?)

What additional sources of funding are being used?:

GIFTS THAT KEEP GIVING