Marie Lamfrom Charitable Foundation

(One sentence)

(If different from physical address)

(If different from above)

(Please put a start and end date)

- Completed Organization Financial Information and Project Narrative form

- Detailed project budget, including revenues and expenditures

- List of board of directors with affiliations and phone numbers

- Organization budget for current year, including revenues and expenditures (one page)

- Most recent audited financial statement, if available, or financial statements for most recent fiscal year

- Organization 501(c)(3) determination letter from the IRS

By submitting this application, I certify the following: (1) The above information is correct; (2) I am authorized by the governing board of this organization to submit this grant application to The Marie Lamfrom Charitable Foundation; (3) this organization is in good standing with the IRS, retains its 501(c)(3) tax-exempt status, and is further classified as a public charity and not a private foundation; (4) this organization does not discriminate on the basis of race, religion, sexual preference, physical circumstances or national origin.

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