Grant Request Form - Mpls Area Synod ELCA

Peer Group Name*
Members of the Group*
Please list names AND email address. Indicate contact person of the group with a *
Requested Grant Money Amount*

Up to $75/each person in group
Amount Group is Contributing*

Matching the requested grant money is encouraged
Date Grant Money is Needed By:*
MM slash DD slash YYYY
Make check payable to:*
Send check to [address]:*
Purpose of Requested Grant Money (noting specific allocations)*
It must fall into one of our three categories: peer-learning, peer-support, spiritual practices
Contact Person*
First Last
Contact Person Email Address*