Wicked Awesome Wishes Grant Program Standard Application


Full name:  

Mailing Address:  

County of Residence:  

Please provide a brief explanation of your financial hardship and the immediate need for which a charitable grant is necessary (3-5 sentences): 

How will receiving this grant assist with relieving your current situation?

Social Security Number:  

 

I understand that by providing my signature I am confirming that (1) the information I have provided on this form is true and complete; (2) Wicked Awesome Wishes may request verification of information provided or additional information to assess grant eligibility; and (3) to my best knowledge my current situation warrants an immediate support grant to accommodate for the unforeseen struggles I and/or my family are currently facing.

Printed Name:  

 

 

Leave this empty:

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Signature Certificate
Document name: Wicked Awesome Wishes Grant Program Standard Application
lock iconUnique Document ID: eca290ba3a86bf0664120db67956bde1abec0a83
Timestamp Audit
September 21, 2023 11:14 am EDTWicked Awesome Wishes Grant Program Standard Application Uploaded by Fiscal Sponsorship - fsp@unitedcharitable.org IP 72.73.25.226