Upper Room Inclusive Catholic Community of the Capital District
PO Box 394, Wynantskill, NY 12198-0394
Tel: 518-952-4172
Community Outreach Fund
Application for Funding
Our Mission: We celebrate as an inclusive Eucharistic community by inspiring and supporting spiritual growth, providing education, and ministering to local and global needs, “living justly, loving tenderly, and walking humbly with God. (Micah 6:8)
Contribution amounts are determined by the Board and applications accepted on an ongoing basis with bi-annual review dates of January and July.
Name of Organization:________________________________________________________
Address:______________________________________________________________
Geographic Area served:_____________________________________________
Contact Person:_______________________________________________________________
Name of Executive Director and Contact Information ______________________________________________________________________
Please include a brief mission statement, overview of your organization and needs that you serve. Include any additional pages that are necessary.
Primary Source of your funding:_____________________________________________________________
# of client served:___________________________________________________
Federal Tax ID # or copy of 501©(3):__________________________________
Return Form to address above or email it to Deven Horne at hornedeven@gmail.com