One-time Technology Grant Request

Congregation City & Name *

Pastor Name *

First

Last

The Pastor is aware of and has approved this grant request *

Church Mailing Address *

Address Line 1

City

State

Zip Code

Requestor/Contact Name *

First

Last

Email *

Phone *

Grant proposal and budget estimate *

Technology grant amount requested (checks will be made out to and mailed to approved congregations) *