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Contribution Funding Application

  1. County of Cumberland, Virginia
  2. External Organization Funding Request Application
    Fiscal Year: 2022 (July 1,2021 - June 30, 2022)
  3. (Should be the same as IRS publication letter and supplied on IRS Form 990)
  4. Funded Services will be provided:*
  5. Duration of Support:*
  6. Number of Clients Served:
  7. Time Frame:
  8. July 1, 2020 - today
  9. July 1, 2019 - June 30, 2020
  10. July 1, 2018 - June 30, 2019
  11. Leave This Blank:

  12. This field is not part of the form submission.