Grant Application

Questions marked with an asterisk (*) are required.
1. Your Information
Please provide your contact information (this section refers to the member of the land title industry):
Name*
First Last
Company*
Is your company an ALTA member?
- Yes
- No
- I don't know
Title
Phone*
Email*
Address
Street Address City State / Province / Region ZIP / Postal Code
2. Organization Contact Information
Please provide complete contact information for the organization you are nominating for a grant:
Organization Name*
Organization Address*
Street Address City State ZIP Code
Organization Website*
Contact Person
First Last
Contact Phone*
(if there isn't a contact person, please include organization's main phone number)
Contact Email*
(if there isn't a contact person, please include organization's main email)
3. Organization Details
Please provide information about the organization you are nominating for a grant. This will be used to evaluate whether the organization is aligned with the mission of the ALTA Good Deeds Foundation.
Mission*
Provide the organization's mission.
501(c)3 Status*
Please provide the organization's Federal Employer Identification Number or Tax Identification Number (EIN). This is usually available on an organization's website or the W-9 form.
Why do you support the organization?*
Please describe why you support this organization and why the ALTA Good Deeds Foundation should support it. The ALTA Good Deeds Foundation will give preference to organizations related to housing issues.
How does the organization relate to the ALTA Our Values?*
Please describe how the organization exemplifies one of the Our Values (We Lead, We Deliver, We Protect).
How do you support the organization?*
Please describe how you or your company have supported the organization within the last 5 years (e.g., volunteering, donating money, donated goods, etc.). An individual’s level of engagement with the organization is an important consideration during the application review, so please make sure to highlight your engagement!
How does the organization impact your local community?*
Please describe how the organization has specifically made an impact on your local community.
Additional Information*
Please share any other general information you think we should know about the organization (e.g., region/location served, chapter of national organization, operating budget, average annual fundraising total, etc.).
CAPTCHA
Consent*
I hereby grant full permission to the ALTA Good Deeds Foundation (AGDF) and its representatives, affiliates or subsidiaries to use, reproduce, publish, distribute and exhibit my name, picture, portrait, biographical information, likeness or voice and any statements, quotes or testimonials provided by me (collectively, “My Likeness”) in connection to AGDF and this grant application.

I acknowledge that AGDF owns all rights to the images and recordings in any medium, including but not limited to, print media and electronic media (including websites, social media, etc.). I hereby waive any right to inspect or approve the use of the images or recordings. I further waive all moral rights. I also waive any right to royalties or other compensation arising from or related to the use of the images, recordings, or materials.

I hereby release, waive, forever discharge, and covenant not to sue AGDF, its governing board, officers, agents, employees, and any members acting on behalf of the AGDF from and against any claims, damages or liability arising from or related to the use of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy, rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

I acknowledge that this consent, waiver, indemnity, release and covenant not to sue is binding on me, my heirs, executors, administrators and assigns. My submitting this application, I acknowledge that I read this document, and I fully understand the contents, meaning and impact of this consent, waiver, indemnity, release, and covenant not to sue.

I agree.

Questions marked with an asterisk (*) are required.

1. Your Information

2. Organization Contact Information

3. Organization Details