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Donor Advised Grant Recommendation Form
Note
: All grants are processed on Friday of each week and mailed for delivery the following week. If you
would like to process the grant as an ACH, please include the account number and routing number of
the non-profit.
Advisor Information
Fund Name
Name of Advisor
*
Advisor Email:
*
On behalf of the Fund, I recommend that the grant listed on this form be considered for funding. I understand that final judgment for processing the grant rests in the hands of the Carolinas Credit Union Foundation and grants will be made only to qualified 501(c)(3) organizations. I verify that, to the best of my knowledge, the grant distributions suggested will be used entirely for charitable purposes and will not be made to pay dues for membership of an individual in an organization, purchase admission to charitable events, or to discharge or satisfy a legally enforceable obligation or personal pledge that has been made by the fund holder or any other individual or organization. It is the practice of the Foundation to identify the specific fund from which a grant is paid to the grant recipient, unless notification to the contrary is provided in writing.
Mailing Instructions
Please return the check to the credit union.
Please mail the check to the grantee.
Attention
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Any special instructions?
Recommended Grant Information
Amount
*
Organization Name
*
Federal EIN Tax ID
*
Contact Name
*
Contact Email
*
Phone Number
*
Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Account Number
What type of account?
Checking
Savings
Routing Number