CCBNA Grant Application
Please Fill Out: *Members Only*
I CERTIFY, TO THE BEST OF MY KNOWLEDGE, THAT:
  1. The tax-exempt status of this organization is still in effect,
  2. This organization does not support or engage in any terrorist activity, and
  3. If a grant is awarded to this organization, the proceeds of that grant will not be distributed to or used to benefit any organization or individual supporting or engaged in terrorism, or used for any other unlawful purpose.
  4. Agree to the collection of pre and post-survey data as required
Signatures:

Executive Director / Date

CCBNA

We appreciate your interest in our organization and invite the opportunity to partner and collaborate.

Email: capitolcitybna@gmail.com

Phone: (916) 248-0853

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