INDIVIDUAL/ORGANIZATIONAL APPLICATION FOR FINANCIAL ASSISTANCE

1. ORGANIZATION OR INDIVIDUAL’S NAME *
2. ORGANIZATION OR INDIVIDUAL’S ADDRESS (If an individual, provide name and address of the sponsoring Welsh organization and the name and address of its officer/contact person.) *
INDIVIDUALS: I agree to have a letter of agreement from that Welsh organization mailed to the Scholarships and Grants chair by the deadline for all materials. *
 YES
 NO
 N/A - Organization application
3. ORGANIZATION OR INDIVIDUAL’S TELEPHONE NUMBER
Cell phone
Email address where the applicant may be contacted by the NWAF
Organizational website address (if any)
4. PERIOD OF SUPPORT--- BEGINNING (mm/dd/yyyy) *
PERIOD OF SUPPORT--- ENDING (mm/dd/yyyy) *
5. PROJECT DESCRIPTION SUMMARY. (Be specific and relate each phase of the project to costs information provided in paragraph seven (7) below.) *
6. IN WHAT WAY(S) WILL YOUR PROJECT BENEFIT WELSH-AMERICAN ACTIVITIES OR THE WELSH-AMERICAN COMMUNITY? *
HOW WILL THE RESULTS OF YOUR PROJECT BE DISSEMINATED TO THE WELSH-AMERICAN COMMUNITY? *
HOW WILL YOU ASSURE THAT ALL FUTURE PERSONAL PUBLICITY WILL ACKNOWLEDGE THE SUPPORT PROVIDED BY THE NATIONAL WELSH-AMERICAN FOUNDATION? *
7. SUMMARY OF PROJECT COSTS. Itemize and identify specific cost areas and indicate if in dollars (USD) or pound sterling (GBP). *
8. LIST PROJECT FUNDING SOURCES INCLUDING YOUR OWN. Be specific regarding the amount you are requesting from the National Welsh-American Foundation. *
9. ORGANIZATIONAL FISCAL ACTIVITY— I will mail financial reports to the Scholarships and Grants Chair where applicable. *
 Yes
 No
10. We (I) certify that the information contained in this application, including all attachments and supporting materials, is true and correct to the best of our (My) knowledge. *
 Yes
 No
I will complete, sign, date and mail the APPLICATION FOR FINANCIAL ASSISTANCE AWARD AGREEMENT to the Scholarships and Grants Chair by the deadline for all materials. *
 Yes
 No
Comments, questions, concerns
Name of person filling out the application *
Title of the person filling out the application (if applicable)
I certify that the responses here and all supporting documentation are complete and correct to be best of my knowledge. *
 Yes
 No
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Mail Copy to
NWAF - Scholarships
24 Essex Road
Scotch Plains  NJ  07076-0247

NWAF Office Telephone – (908) 889-4942

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