CHS Seeds for Stewardship Grant Application Form CHS Seeds for Stewardship Organization Name*Organization Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Federal Tax Exempt Number or EIN Number*Tax Exempt IRS Letter(if applicable)Organization Contact* First Last Contact Title*Phone*Email* Briefly describe the organization you are requesting funds for*How does your organization/project connect to CHS?*(member-owners involved, located in community, etc.)If you are awarded funds, do you agree to complete an evaluation report at the completion of the project?*YesNoProgram/Project Budget*Total Requested Amount*Title of Program or Project*Provide a brief summary of the program/project*List at least three specific, measurable goals*How will these goals be measured to determine success?*Please attach a budget of program/project*Age Group* Adults College Youth Select all those that will benefit from the program/projectAny additional documents to include?