Prefix |
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Address |
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Type of Organization
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First Name |
* |
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Address |
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Mission Area(s)
Select all that apply |
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Middle Name |
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City |
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Last Name |
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State |
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Title |
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Zip Code |
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Organization
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Country |
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Phone |
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E-Mail |
* |
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Web Site |
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This item is optional. The USDA Center welcomes and works with all faiths and affiliations an secular organizations.
Information shared with the faith-based and neighborhood partnerships office will not impact USDA funding applications.
Sharing an organization's faith affiliation is not required in order to receive USDA Center notices and participate in initiatives and activities.
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Organization's Religious Affiliation. |
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Received USDA Grants, Reimbursements or Other Support in the Last Fiscal Year. please select Yes or No. |
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Yes |
No |
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Note: All the fields marked with an asterisk (*) must be completed.
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