Charity Grant Request Over $100

Organization Name*

Date*

Contact Person*

All requests MUST come from a current OmniTel customer.

Title*

Address*

Street Address City State ZIP Code

Phone*

Email*

Check to be made out to*

1. Describe your organization and its purpose.*

2. Describe the proposed project.*

3. In which OmniTel community is the event taking place?*

4. Please detail necessary supplies and costs.*

5. Dollar Amount Requested*

6. Is this an annual project?*

7. When is the event or project to be completed? (Proof of completion is required within one month of the event)*

8. How will OmniTel be recognized?*

9. OmniTel Grants are for non-profit organizations only. Please provide your Tax Exempt Number (schools, churches, scouts & county fairs do not need this information)

10. Projected Budget

Do you (or does this organization) have a presence on Facebook?*

We strongly encourage that at least one member of the organization requesting an OmniTel Charity Grant have a Facebook presence so they can use OmniTel’s Facebook Wall to promote their project. We believe that posting a description of the project, explaining how this project will benefit others and posting periodic updates of the project’s progress is another way in which the organization can make and maintain strong community connections.

Would this organization be willing to post periodic updates on OmniTel's Facebook Wall?

We strongly encourage that at least one member of the organization requesting an OmniTel Charity Grant have a Facebook presence so they can use OmniTel’s Facebook Wall to promote their project. We believe that posting a description of the project, explaining how this project will benefit others and posting periodic updates of the project’s progress is another way in which the organization can make and maintain strong community connections.

Would this organization be willing to post periodic updates on OmniTel's Facebook Wall?*

If you or your organization does not have a presence on Facebook, email us at facebook@omnitel.biz and we will be delighted to help you.

I agree should my organization fail to complete the project within one calendar year, all monies will be returned to OmniTel Communications.

IMPORTANT INFORMATION Please note, grants are awarded quarterly in January, March, July and October only. Please apply for the grant the quarter prior to when the funds are needed. Requests have been maximized at $1,000 per each request to benefit civic organizations, $500 for non-civic groups, $250 to school activities and $250 for summer youth programs. It is unlikely that an individual or private group that does not include the community as a whole, will be awarded a grant.

Phone

This field is for validation purposes and should be left unchanged.

OmniTel Communications’ Charity Grant Program