Phase 41 Emergency Food & Shelter Program (EFSP) Form

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Type of Agency
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DEADLINE FOR SUBMISSION: Tuesday, April 16, 2024 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, 3444 Quaker Bridge Rd, Bldg 3, Suite 101, Hamilton, NJ 08619

PART I - Agency Information

Agency Information

Agency's Name

Address

City/Town

State

ZIP/Postal Code

Mailing Address

City/Town

State

ZIP/Postal Code

Agency's Phone Number

Agency's Fax Number

Agency's Web Address

EIN Number

Unique Entity Identifier (UEI)

All entities doing business with the federal government or receiving federal funds must use the UEI created in the System for Award Management (SAM.gov).

Primary Contact Information

Primary Contact First Name

Primary Contact Last Name

Primary Contact E-Mail Address

Primary Contact Phone

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Phase 41 Emergency Food & Shelter Program (EFSP) Form

PART I - Agency Information

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