Track Shack Foundation Application Process..................

Organization Name (required)

Applicant Contact Name (required)

Applicant Title

Phone Number (required)

Fax Number

Organization's E-mail (required)

Website Address

Tax Status (required)
[Ex: 501 (c)(3)]

Is organization a School? (required)
Yes NoPlease select one.

Tax ID Number

Does your Organization file a 990?
YesNo

In 300 words or less please provide a brief description of your organization and mission (required)

In 300 words or less please list ways your organization raises funds to support its financial needs (required)

Organization Type (required)
Choose One Public School Private School Health Charity Athletic Organization Fundraising Event Other Please specify

Organization Location (required)

Event/Program Name (required)

Name and Exact Date of Event/Program [Ex: Walk-a-thon Challenge on January 1st 2020] (required)

Amount of Request (required)
$

In 300 words or less please provide details about your event/program and briefly describe how the funds are to be spent (required)

If full funds are not available, will partial funding help? (required)
Yes NoPlease select one.

In 300 words or less please provide a list of existing contributors and additional sources of income (required)

Please estimate how many people will be served by this program (required)

In 300 words or less please provide a line item of expenses for the program/project for which you are applying [Ex: $100 T-shirts, $20 Supplies...] (required)

Select the age group primarily impacted by this event/program (required)
Choose one 5-17 18-25 25-50 50+ All age groups

Select the geographical area (county) primarily impacted by this event/program (required)
Choose one Orange Osceola Lake Volusia Seminole Brevard Other Please specify

Select the gender primarily impacted by this event/program (required)
Choose one Male Female All genders

Select the ethnic group primarily impacted by this event/program (required)
Choose one Caucasian (non-Hispanic) African American Hispanic Native American Other Please specify