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2. 
4. This is the Application for Non-Profit Organizations
6. Agency Name:*
8. Contact Name:*
10. Contact Email:
12. Contact Phone:
14. Reason for Funds Request:*
16. Amount of Funds Requested:*
18. Proposed Use of Funds:*
20. Evidence of Non-Profit Status:*
21. Non-Profit Status Documentation:
23. Year Non-Profit Established:*
25. Verification Business Operates in Newton County*
27. Narrative:*

    Please explain why your proposed use is an appropriate use of ARPA funds.

29. 
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field