APPLY FOR ASSISTANCE In seeking assistance, the Not-For-Profit organization is required to complete this application form, providing background information on the organization requesting support and an outline of the outcomes anticipated. Each project will be conducted during the length of the course. Deacon Daniel J. Ianniello Phone: 203-371-7853 Fax: 203-365-7609 Email: ianniellod@sacredheart.edu Organization Name: * Street Address: * City: * State: * - Select Ones - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP Code: * Contact Person: * Phone: * ### - ### - #### Fax: ### - ### - #### Email: Current Staff Size: Website: BACKGROUND When was your organization founded?: Does your organization have 501(c)3 status?: * Describe your organization, its purpose & its goals: * PROJECT PROPOSAL Describe the project you would like the Center to undertake. Include a description of the project's purpose and desired outcome: * *The Center reserves the right to accept or reject projects at its sole discretion and to assign student with backgrounds it deems appropriate. Do Not Fill This Out
