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2024 DPAA Service Grant Application
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* Indicates required question
Email
*
Your email
Name of Organization Applying for Grant
*
Your answer
Name & Title of Contact Person
*
Your answer
Name of Person Administering Grant (if different than above)
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Website
*
Your answer
Your Mission Statement
Your answer
Describe your Organization's history, purpose, and who you serve.
*
Your answer
For Organizations, list your board members/executive staff.
Your answer
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