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	USTA/Maryland Community Grant Cover Sheet
USTA Organization ID Number:
Name of Organization:
Address:
City, State, Zip:
Phone Number:
Fax:
Website:
Ex. Director/CEO/Presidents Name:
Phone:
Email:
Contact Person for this application:
Summary of Grant Request (one or two sentences):
Grant Request $ (not to exceed $1,000):
Total Number of Participants:
Project/Program's total budget:
Fiscal Year: