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Please provide your office address (Please note that the office must be in the county you are applying for). *

How many people does your organization serve locally? *

Please tell us about your organization *

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Date

Organization Name *

Where is the event being held? *

Thank you for visiting us and participating in the Dyer Difference Award. Please fill out the form below to complete your application. Applicants must have a valid and active 501(c)(3) certificate and may only submit once every 6 months.

For more information please contact us to dyerdifferenceaward@gmail.com

Which County Does Your Organization Serve? *

Indian River County

St. Lucie County

Polk County

Phone Number

EIN Number *

Do you have an event you would like us to support? If so, please describe the event. If not, please describe how your organization would use the funds.(An event is not required to receive the grant) *

Date

Email *

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Please upload your valid and active 501(c)(3) certificate *

Contact Person's Name *

Website URL

What is the date and time of this event? *

Empowering our communities, accelerating the future.

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