If you represent a Virginia-based organization, you are eligible to participate.
Complete the application below.
Every two months we will make donations from the submitted requests.

Name of organization:
Name of primary contact:
Address
Street:
City/State:
Zip:
Phone Number:
Email
Is the organization for profit or non-profit?	Profit Non-profit
What cause or mission does the organization serve?

Is there a specific event/function that the organization needs help with?:
Type of event
Name of event
Date(s) of event

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