Town Council Annual Charitable Donation Request

2. Application Instructions
   Please fill out the form in its entirety. Application deadline is March 1st of each year. Consideration by the Town Council is typically at one of their regular April meetings, and funding is dispersed within 2 weeks after approval. To view upcoming meeting agendas, visit www.jupiter.fl.us/agendas and click on "Town Council".

   Please fill out the form in its entirety. Application deadline is March 1st of each year. Consideration by the Town Council is typically at one of their regular April meetings, and funding is dispersed within 2 weeks after approval. To view upcoming meeting agendas, visit www.jupiter.fl.us/agendas and click on "Town Council".

4. Contact First Name*

5. Contact Last Name*

7. Organization Name (must be 501(c)3 to be considered)*

9. Address1*

11. Address2

13. City*

14. State*

15. Zip*

17. Contact Phone*

18. Contact Email*

22. 501(c)3 Designation*

    Please upload a copy of your organization's 501(c)3 designation.

23. Requested Amount of Donation*

25. Past Recipient

    If you are a past funding recipient, please include information on the success of the past programs/services and how past funding amounts were put to use or applied to those programs/services

27. Programs/Services Donation is Intended to Support

29. Program/Service Name

30. # of Jupiter Residents Served Annually

31. Program Description and Benefits

33. Program/Service Name

34. # of Jupiter Residents Served Annually

35. Program Description and Benefits

37. Program/Service Name

38. # of Jupiter Residents Served Annually

39. Program Description and Benefits

41. Program/Service Name

42. # of Jupiter Residents Served Annually

43. Program Description and Benefits

45. Program/Service Name

46. # of Jupiter Residents Served Annually

47. Program Description and Benefits

49. Additional Information

    Please share any additional information on your organization, programs or services that is not included above.

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field