Grant Application Form Page 3

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Any questions regarding this application process should be referred to Kelly Thompson,
Executive Director at 217-528-3314 X 145 or .
Ronald McDonald House Charities of Central Illinois
Grant Application Form
1. Organization
Name of Organization:
Address:
City:
County:
State:
Zip code:
Contact person:
Title:
Telephone:
Specific amount of this grant request:
Has your organization received funding from RMHCCI within the last five years?
Yes / No If yes, how much was received, what date(s) and for what purpose?
Please name the McDonald’s owner who you are working with on this grant.
Name:
Address:
City:
State:
Zip code:
Telephone:

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