USANA Foundation Matching Grant Application
Please fill out this application with as much information as possible in order to assist with the grant set-up process.
* Required
Applicant first and last name:
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Your answer
Applicant USANA associate ID:
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Your answer
Applicant email address:
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Your answer
Applicant phone number:
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Your answer
Applicant Facebook ID (if applicable - please write N/A if you do not have a Facebook ID):
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Your answer
Name of the organization for which you wish to fundraise:
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Your answer
Name of your primary contact at this organization:
Your answer
Phone number of primary contact at organization:
Your answer
Email address of primary contact at organization:
Your answer
Website of organization:
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Your answer
Country of Impact:
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Your answer
What is the percentage of overall income used on non-charitable activities (administration cost)? *Please note that an administration cost of over 10% may delay the approval process.
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Your answer
Are you applying for a $500 grant, a $1000 grant, or a $2500 grant? (If this is your first fundraiser you will only be allowed to fundraise up to $1000 USD or your local currency equivalent)
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Your answer
What type of food program will this grant help pay for? Please confirm with the organization before submitting this application.
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Your answer
How many people will be impacted by this grant?
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Your answer
How many meals will be distributed as a result of this grant?
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Your answer
Applicant's electronic signature
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Your answer
Date of application submission
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