Sisters of St. Joseph of the Third Order of St. Francis.

Name:
Title
Organization:
Street Address:
Address (cont.):
City:
State/Provence:
Zip/Postal Code:
Country:
Phone:
Fax:
E-mail:
Please describe the program or project for which you are requesting funds.
Describe the need.
Describe the results hoped for, if request is granted.
How does your program or project fit our criteria?
Are you a not-for-profit organization?	Yes No If yes, send a copy of 501c3 IRS letter, or a letter from your fiscal agent along with their 501c3 IRS letter.
Have you previously received financial help from the SSJ-TOSF Contributions Fund?	Yes No If yes, when and for how much?
Do you relate to any Sisters of St. Joseph of the Third Order of St. Francis?	Yes No If yes, who?
Is the program or project for which you are seeking funds an SSJ-TOSF ministry?	Yes No
Amount requested
To whom would the check be payable?
	This request will be considered when we receive five copies of all of the following: Application Form Most recent budget Current financial report List of Board of Directors List of other funders and amounts
Please send to:	Sr. Dorothy Pagosa, Chairperson Office for Social Justice Sisters of St. Joseph, TOSF 205 W. Monroe Chicago, IL 60606