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".
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