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Contact Person's Name
First and Last Name
Phone Number
xxx - xxx - xxxx
E-mail Address
Enter your e-mail adddress
Our Business is a U.S. Business
Business Name
Business Mailing Address
Street address, City, State, Zip
What services does your business provide?
Business Start Date
If you have not been in business for at least 2 years, AGWA will not be able to provide services.
Annual Business Revenue
Less than $50,000 annual revenue
We will not be able to provide services.
$50,000 to $100,000 annually
More than $100,000 annually
Type of Business Structure
Nonprofit Organization
Charitable 501c3
For Profit Business
Local Government Agency
Native Tribe
Individual
Sorry, we only accept business clients
If the business has a website URL please provide
What are you seeking to fund from future grants?
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