Recommend a Grant From My Fund

Personal Information
Your Name*
First Last
Your Email Address*
Your Phone*
Fund & Grant Distribution
Fund Name

The fund name from which distributions will be sent. Distributions will be sent to approved organizations within 30 days after receipt of this completed form.

Your quickest route to answers about your gift or your fund?
Contact: Mary Pickens, Donor Services Director
[email protected]
Recipient Organization*
Gift Amount*

(Minimum Distribution of $100.00)
Organization Address (if available)
Street Address Address Line 2 City State ZIP Code
Organization Contact (optional)
First Last
Organization Contact Email Address (if available)
Organization Contact Phone (if available)
Distribution Method*
- Standard action: Mail check to the above named
- Call me, I will pick-up check
Do you wish this gift to be anonymous?*
- Yes
- No
Memorial or Honorarium Gift
Complete this section ONLY if distribution is a memoriam or an honorarium: A letter advising of your gift without reference to the amount can be sent to the person or to their family. Please provide pertinent information below.
Tribute designation
- Memoriam (In memory of)
- Honorarium (In honor of)
Name(s)
Please send an acknowledgement letter to:
Street Address Address Line 2 City State ZIP Code
Agreement
Agreement*
I agree to the terms and conditions
The above suggested distribution does not represent the payment of any pledge or financial obligation. No goods or services were received in consideration for this gift. I understand final judgment rests with the Board of Directors whose charge it is to see that all distributions are within the purposes of Foothills Community Foundation.
Signature*
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Recommend a Grant From My Fund

Personal Information

Fund & Grant Distribution

Memorial or Honorarium Gift

Agreement