Backer Application
By completing this form, you are confirming your availability to participate during the 24 Hour Citizen Project event at the Omni Center (Downtown Lafayette) on Saturday, November 9th from 430PM - 9PM.
Name *
Your answer
Email *
Your answer
Phone number *
Your answer
Organization Name *
Your answer
Areas of Interest (tell us about specific areas of interest you may have in the community) *
Your answer
Pre-committed Funds (We encourage a pre-commitment of at least $1,000. The amount below is not binding. Having this amount will help us estimate the amount of funds committed prior to the event.) *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service