Phase 40 Emergency Food & Shelter Program (EFSP) Form

Current Start
Type of Agency
Type of Funding Requesting
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DEADLINE FOR SUBMISSION: Thursday, March 9, 2023 1:00 pm. Late or incomplete applications will not be accepted. Applicant must meet all requirements outlined.

A copy of your responses will be emailed to John Santana at john.santana@uwgmc.org and you will also receive a copy at the email provided.

Mercer County Local EFSP Board 598800 c/o United Way of Greater Mercer County, 3150 Brunswick Pike, Suite 230, Lawrenceville, NJ 08648

PART I - Agency Information

Agency Information

Agency's Name

Address

City/Town

State

ZIP/Postal Code

Address

City/Town

State

ZIP/Postal Code

Agency's Phone Number

Agency's Fax Number

Agency's Web Address

EIN Number

Primary Contact Information

Primary Contact First Name

Primary Contact Last Name

Primary Contact E-Mail Address

Primary Contact Phone

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