Change for Community Application

Selling groceries might keep our store in business, but giving back to our community is at the heart of what we do. Change for Community reaps big rewards for community nonprofits.

Organization Name
Non-profit Tax ID#
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Contact Person
First Last
Email
Website
Social Media
Describe your organization’s mission and current funding sources.
You may upload additional information or literature in the next field.
Mission/Funding Uploads
Drop files here or

Accepted file types: pdf, Max. file size: 8 MB, Max. files: 3.
Explain how the funds would be used to benefit our community.
Have you been a Change for Community recipient in the past?
- Yes
- No
We want to make Change for Community successful, so would you agree to help with some press? Could you share that you’re a recipient in the following ways?
Please check all that apply.
- social media
- email/newsletter
- web site
- other
Other way that you could share:
Would you be up for a photo at our check presentation ceremony and a quote which would be shared on our social media, web site, email and possible press release?
- Yes
- No
Date*
MM slash DD slash YYYY
Opt in*
I agree to the privacy policy.

Community Owned.Everyone Welcome to Shop!

Community Owned.

Everyone Welcome to Shop!