Step 1 of 2 50% Information About Applicant Organization/RequestDate of Application* MM slash DD slash YYYY Organization Name*Type of Organization*Number of People Served*Federal ID #*Date Founded* MM slash DD slash YYYY Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address Is your mailing address different than your business address? Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Organization Phone*Website*Project Contact Person*Project Contact Phone*Project Contact Email* Project Contact Person Title*Current tax-exempt status*501©(3) and (509)(a)Other(If exempt under another organization, include evidence from IRS of that exemption and the relationship between the exempt organization and the applicant organization.)Number of Stuffed Animals Requested*Additional FilesMax. file size: 100 MB.(if applicable)Please provide the exact quantities of each type of stuffed animal you are requesting below.Philbin the Bear - BeigePhilbin the Bear - ChocolateKarina the LabradoodleRandle the Bernese Mountain DogKian the SpanielMuttsy the DogDate Needed* MM slash DD slash YYYY Project Program Description* Request AuthorizationTerms I certify that the above information is correct and that the governing board of this organization has approved submitting this grant application to The Shapira Foundation -HUGPATROL PROGRAM. Person authorized to sign on behalf of requesting organization*Title*Date* MM slash DD slash YYYY