First name*
 
 
 
 
Last name*
 
 
 
 
Email*
 
 
 
 
Organization*
 
 
 
 
EIN
 
 
 
 
What is your role at your organization?
 
 
 
 
What county/counties does your organization service? (Select all that apply.)
 
 
 
Other
 
 
 
 
What focus areas align with your organization? (Select all that apply.)
 
 
 
Other
 
 
 
 
Would you like us to send more information and/or speak with a United Way staff member about the following free resources? (Select all that apply.)
 
 
 
Other
 
 
 
 
I am interested in learning about these grant opportunities as they become available:. (Select all that apply.)