NONPROFIT APPLICATION Full Name*Email Address* Is your organization based out of Atlanta and/or directly benefit the Atlanta community?*YesNoIs your organization tax exempt under section 501(c)3 or (19) of the Internal Revenue code with a valid tax exempt number?*YesNoIs your organization a recognized government entity that is requesting funds exclusively for public purposes, a school, or a churn or faith based organization?*YesNoWhat is your organizations name?*How long has your organization been founded / operating?*What is your mission statement?*If you were to receive funding from Dine for Atlanta, what would it go towards? (please break down percentages based on program / initiative if possible)* This iframe contains the logic required to handle Ajax powered Gravity Forms.