Apply for a Grant from the Bridgestone Americas Trust Fund

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First Name*

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Last Name*

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Contact's Email Address*

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Phone*

Organization Information

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Organization Name*

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Street Address*

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Apt./Suite

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City*

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ZIP Code*

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We consider contributions to a variety of causes and organizations. Categories we consider regularly are listed below. Please select the one that most applies to your organization or program.*

Education

Welfare of Children

Environment and Conservation

Other

Tell us about your organization

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What are some of the key accomplishments of your organization?*

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What are the key objectives of your program?*

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Who would benefit from your program?*

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What method(s) would you use to evaluate the program's success?*

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Help us understand the level of contribution you're seeking

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What dollar amount are you seeking in relation to the total need?*

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How would your organization use Trust Fund money? (Be as precise as possible)*

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Please share some information to help us evaluate need

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Current year's operating budget, if available*

Tax-Exempt status

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Non-Discrimination

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Who are the members of your Board of Directors?

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Member 1*

Name*
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Title*
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Member 2

Name
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Title
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Member 3

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Title

Please list other contributors and the amount oftheir donation

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Contributor 1*

Name*
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Amount of Donation*
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Contributor 2

Name
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Amount of Donation
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Contributor 3

Name
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Contributor 4

Name
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Amount of Donation
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Contributor 5

Name
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Amount of Donation
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If benefits are involved, please describe the breakdown of deductible vs. non-deductible portions

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Proposals meeting basic criteria requirements are held for review by the bridgestone Americas Trust Fund committee, which meets several times throughout the year. Subsequent to the review, applicants will be notified of the committee's decision.