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Electronic Project Request Form

Hometown Civitan Club

Project Request

Proposed Project Start Date

Submitted by:

Email of Submitter

Project Name

Phone Number of Submitter

Project Objective (Reason for doing the project/what it will accomplish)

Brief Description of the Project (Email any additional supporting documentation or information, including cost estimates)

Benefitting Organization/Charity and Contact Person

Project Source of Monetary Support:

HCC

SPONSOR

FUNDRAISER

OTHER

Volunteer Resources (Include number, time and duties)

Thanks for submitting!

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