Organization*
 
 
First Name*
 
 
Last Name*
 
 
Title*
 
 
Street Address*
 
 
Address Line 2
 
 
City*
 
 
State*
 
 
ZIP Code*
 
 
 
Phone
 
 
 
Email*
 
 
 
Employer Identification Number (EIN)*
 
 
 
Are you a registered 501(c)3 organization?*
 
Yes
No
 
 
Please describe the event, project, or program for which you are requesting funding. Include the target audience, number who will be impacted, timeline, overall budget and how it will be funded. (200 word maximum) 
Project Description*
 
 
Other Funding Sources*
 
 

Briefly describe the goals and expected outcomes of the project.

 
Goals and Outcomes*
 
 
Project Location*
 
 

By checking this box and submitting this grant application, I agree to allow Invenergy LLC or any of its affiliates ("Invenergy") to photograph me at an awards ceremony if selected as a scholarship recipient. I hereby grant to Invenergy consent and the irrevocable right to use my likeness in a photograph, video, or other digital media ("ldentity") in any and all of its publications, including web-based publications, without payment or other consideration, for any duration, and waive and release Invenergy from all claims and liability from the use of my Identity.

 
I agree*