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Applicant Information Request Form

- Light for Beaufort

If your agency or organization has received an information letter, you have been selected by the St. Peter's Service Committee for consideration of funding. Please complete the following form to tell us a little more about your organization.
If you have an interest in becoming a St. Peter's grant recipient, please contact the Service Committee Chair at [email protected].
Applicant Information Request Form
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- Organization's Name REQUIRED Please fill out this field. Please enter valid data.
- Year Founded REQUIRED Please fill out this field. Please enter valid data.
- Organization's EIN (if 501 (c) (3) Public Charity) REQUIRED Please fill out this field. Please enter valid data.
- Organization's Mission Statement REQUIRED Please fill out this field.
- Mailing Address (Street and/or P.O. Box, City, State, Zipcode) REQUIRED Please fill out this field.
- Physical Address, if different from Mailing Address
- Telephone Number REQUIRED Please fill out this field. Please enter valid data.
- Organization's General Email Address REQUIRED Please fill out this field. Please enter valid data.
- Website Address Please enter valid data.
- Are you using a Fiscal Sponsor Organization for this project? Yes No
- If yes, please provide the following:
- Organization's Name Please enter valid data.
- EIN Please enter valid data.
- Year Founded Please enter valid data.
- Appropriate Contact Person Please enter valid data.
- Mailing/Physical Address
- Telephone Number Please enter valid data.
- Do you have a Board of Directors? Yes No
- Do you have By-Laws? Yes No
- Name of Executive Director (or Equivalent) REQUIRED Please fill out this field. Please enter valid data.
- Executive Director's Email Address REQUIRED Please fill out this field. Please enter valid data.
- Briefly, if awarded monies from St. Peter's, for what purpose would they be utilized? REQUIRED Please fill out this field.
- What percent of the services you provide benefit Northern Beaufort County (North of Broad River) residents directly? REQUIRED Please fill out this field. Please enter valid data.
- Name and Title REQUIRED Please fill out this field. Please enter valid data.
Submit

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