|
|
|
|
Total Number of Grants*
|
|
|
|
|
|
|
|
|
Dealership Name*
|
Mailing address 1*
|
Mailing address 2
|
|
|
|
|
|
City*
|
State*
|
Zip Code*
|
|
|
|
|
|
Primary Contact: First Name*
|
Primary Contact: Last Name*
|
Business Email*
|
|
|
|
|
|
|
|
FFA grant recipients send thank you notes to the dealerships that sponsor them. If the thank you should be sent to a contact that is different from the primary contact, enter the thank you contact information below. If the thank you should be sent to the primary contact, skip the section below.
|
|
|
Thank You Contact: First Name
|
Thank You Contact: Last Name
|
Thank You Contact: Email Address
|
|
|
|
|
|
Thank You Contact: Street Address
|
Thank You Contact: City
|
Thank You Contact: State
|
|
|
|
|
|
Thank You Contact: Zip Code
|
|
|
|
|
|
|
|
|
FFA Chapter Information
|
|
The dealership would like to award grant(s) to the following FFA chapter(s).*
To find a local FFA chapter, search here.
|
|
|
Chapter 1 Name*
|
Chapter 1 City*
|
Chapter 1 State*
|
|
|
|
|
|
Chapter 2 Name
|
Chapter 2 City
|
Chapter 2 State
|
|
|
|
|
|
Chapter 3 Name
|
Chapter 3 City
|
Chapter 3 State
|
|
|
|
|
|
Number of Grants for Chapter 1
|
Number of Grants for Chapter 2
|
Number of Grants for Chapter 3
|
|
|
|
|
If you would like to provide more than three grants, please contact Anna Van Ness at avanness@ffa.org. The maximum number is five grants per dealer.
|
|
|
Payment Options (choose one)*
|
|
|
|
|
I understand that by submitting this form, I agree to this contribution. *
|
|
|
|
I acknowledge that this gift is subject to the policies of the National FFA Foundation which includes, but is not limited to, a policy that allows for scholarships to be rolled over for one year after which the funds will be released to the general scholarship fund.
|
|
|
| | |