Support Organiza.on Informa.on Submission to Request Recogni.on

Organiza2on Name [exactly as listed in 501(c)(3) ﬁling] __________________________________________________

Status of 501(c)(3) ﬁling: □Registered	□Pending

EIN # ___________________________________

Organiza2on Websites/Social Media: _________________________________________________________________

_______________________________________________________________________________________________

Purpose of Organiza2on: __________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

List all Ac2vi2es, Sports, or Interest Groups that are intended to be supported: _______________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Leadership:

Oﬃcer Title
	Name
	Contact Email
	Contact Phone

				

				

Please send any changes in Leadership informa2on to the Treasurer ASAP.

Rev 0 March 2024