Eligibility Inquiry This form is for first-time applicants to determine if your organization and grant request is eligible for funding by the NHEC Foundation. Upon approval, you will be asked to submit further documentation with your grant application as outlined in the Guidelines. Contact InformationName of Organization* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Person* First Last Email* Phone Number*Project/Program DescriptionProject/Program Title* Amount of funds you are requesting*Please give a brief description of what funding will support*Does your proposed project or program have other funding sources lined up, either financial or in-kind? If yes, please specify each source below:*Please list the geographic areas this grant will serve*How did you hear about the NHEC Foundation?*Is your organization a non-profit 501(c)3?* Yes No Digital SignatureI understand that by submitting this form I am only inquiring if my program/project is eligible for grant funding. If my project is eligible, a full grant application must be submitted on or before the application due date which is always the 1st day of each respective month in which the Foundation Board meets.Name* First Last Date* MM slash DD slash YYYY CAPTCHA Δ