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Social Service Funding Application

  1. What percent of your operation is funded by:

  2. Specify below.

  3. Are programs, services, activities, and facilities provided by your agency available to residents of Vernon Township?

  4. Is your operation age or gender specific?

  5. Do you charge for your services?

  6. If yes, do you charge on a sliding scale?

  7. Do you use volunteers in your program?

  8. Examples: new personnel, programs, goals, facilities.

  9. Please submit a copy of your organization's last fiscal year certified audit. Submit documentation showing status of non-for-profit.

  10. Leave This Blank:

  11. This field is not part of the form submission.