COMMUNITY SUPPORT APPLICATION

After completing this application, return with any other supporting documentation concerning your community event or organization, and a copy of your 501(C)3 Certification (if applicable) to: Wheat State Technologies, Attn: Berniece Millsap, PO Box 320, Udall, Kansas 67146. Documents can also be faxed to 620.782.3341 or emailed to bmillsap@wheatstate.com. This application should be submitted thirty (30) days prior to your event.

Step 1 of 3

Organization / Group Name *

Federal Tax ID Number *

Do you have 501(c)3 non-profit certification? *

Contact Name *

First

Last

Contact Title *

Organization Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Fax *

Email *