Financial Asst Request Form
IMPORTANT: This year we will be doing in person proposals. The meeting will be held on November 21st 2022 at Murray Hall located in the Creston Park.
The new form attached is what the Creston Community Service Club needs to process any requests for financial assistance. Please fill out this form and return it to CCSC c/o H. Uhler, 202 S Crestview Dr., Creston, OH 44217 on or before November 20th.
Thank you for your help.
Creston Community Service Club
Request for Financial Assistance
To be considered for funding from the Creston Community Service Club, the following questions need to be answered and returned to CCSC, c/o H. Uhler, 202 S Crestview Dr.,, Creston, OH 44217 on or before Nov. 20th Thank you.
Name of Organization: _______________________________________________________
Contact Person: _____________________________________Phone: __________________
Email address: ___________________________ Number of Individuals in the program ____
You are a: School Program ____ Community Program ____ Private Organization ____
New Program ____ Existing Program ____
Organizations yearly income ________________ Organizations yearly expenses _________________
Primary source of funding comes from: ________________________________________________
List Fund Raisers that your organization has done or plans to do in the current year: ___________
Your request for funds from the CCSC will be used for the purpose of:_______________________
Does your organization help at the Creston Ox Roast, if yes, please explain: ______________________
Additional Comments: ______________________________________________________________
_______________________________________________ ____________________________ Signature Date