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Home
Our Story
About Us
History
Board
Our Impact
Our News
Volunteer Stories
Homeowner Stories
Our Services
Our Services
Apply
Our Partners
Overview
Corporate & Community Partners
Volunteers
Private Donations
Photographer Credits
Contact
"It Just Needs Done"
(563) 260-3143
Home
Our Story
About Us
History
Board
Our Impact
Our News
Volunteer Stories
Homeowner Stories
Our Services
Our Services
Apply
Our Partners
Overview
Corporate & Community Partners
Volunteers
Private Donations
Photographer Credits
Contact
Non-Profit Application
Name of Organization
*
Name of Executive Director
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Mailing Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
Site Address (if different)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Site Contact Person
Site Contact Phone
Purpose of organization and whom it serves
*
What is the organization’s major source(s) of funding?
*
REPAIR WISH LIST – What are four most important repairs needed?
*
Describe how the renovations will impact your clients
*
Is this space:
*
Owned
Leased
What is the length of the lease?
*
Lessor's Name
*
Lessor's Phone
*
Will the repairs done by Rebuilding Together impact the lease? (Explain)
*
Why should you be chosen as a recipient of Rebuilding Together Muscatine County?
*
Please mail the following information with the application:
Organization budget – past 2 years
Current fiscal budget
Proof of 501(c)(3) status
List of Board of Directors and their professional affiliation
I/we certify that the above information is true and correct to the best of my/our knowledge. I/we realize that failure to provide all information requested could result in our application being invalid. I/we authorize you to check any references necessary to complete the processing of this application for the purpose of receiving facility rehabilitation through Rebuilding Together Muscatine County. I/we also understand that any information received will be kept confidential and will be used strictly for determining my/our eligibility for this program.
*
I agree
Δ