DATE OF APPLICATION. NAME, ADDRESS, TELEPHONE NUMBER, FAX NUMBER AND FEIN OF APPLICANT. COPY OF CURRENT, IRC SECTION 501(C)(3) DETERMINATION LETTER. LISTING OF ALL BOARD MEMBERS, OFFICERS AND PRINCIPAL EMPLOYEES. BRIEF STATEMENT OF AMOUNT REQUESTED AND PURPOSE FOR WHICH FUNDS WILL BE EXPENDED. BRIEF STATEMENT DETAILING THE HISTORY, PURPOSES AND GOALS OF ORGANIZATION. CURRENT SET OF FINANCIAL STATEMENTS OF ORGANIZATION (BALANCE SHEET, STATEMENT OF REVENUES, EXPENSES AND CHANGES IN FUND BALANCES AND DETAILED DESCRIPTION OF OPERATING EXPENSES, SALARIES AND SOURCES OF INCOME OF VARIOUS PROGRAMS). COPY OF FORM 990.

MUST BE NOT-FOR PROFIT RULED TAX EXEMPT BY THE INTERNAL REVENUE SERVICE UNDER PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.