Jeremiah Fund Complete the form below to apply for access to the Jeremiah Fund. Step 1 of 3 33% Contact InformationName* First Last Email* Address* Street Address City State / Province / Region ZIP / Postal Code Phone*I am a member of First Free Rockford* Yes No I am actively serving as a volunteer in the organization I'm requesting a Jeremiah Fund grant for.* Yes No I am willing to personally deliver the grant.* Yes No Grants from the Jeremiah Fund will only be distributed to organizations where First Free Rockford members are actively serving as volunteers. Members must be willing to personally deliver the grant check. If you are not a member, please consider becoming one. Learn more about membership on the First Free Rockford website. Organization InformationTell us about the organization you are seeking a grant for and your involvement in their work.Organization Name*Please list the complete name of the organization. Executive Director's Name* Executive Director's Email* EligibilityTo be eligible for a grant from The Jeremiah Fund, organizations must meet a variety of criteria. Please answer the questions below to the best of your ability.This organization is a local, registered 501(c)3 non-profit* Yes No This organization is morally positive and spiritually neutral or Christian faith-based.* Yes No Is this organization political in nature?* Yes No This organization seeks the flourishing of the Rockford area.* Yes No If the organization you are seeking a grant from The Jeremiah Fund for does not meet the eligibility criteria set by the First Free Rockford Board of Elders, First Free Rockford will be unable to give a grant from the Jeremiah Fund to this organization.Organization Address*Please include complete address, street of P.O. Box number; city, state and zip codeOrganization Website Address* What is the mission of this organization?* Personal Involvement InformationWe want to hear your story of listening, learning, and living in the city of Rockford.How do you see this organization contributing to the flourishing of Rockford?*How did you hear about this organization?*What drew you to volunteer with this organization?*In what role(s) have you served with this organization?*Tell us one story about your service with this organization.*My answers on this application may be used to develop church-wide and web-based (public) communications.* Yes No Thank you for taking the time to apply for a grant from The Jeremiah Fund. Please press "submit" below to complete your application. 3201
