Individual Grant(s)

Thank you for considering Divas In Defense to empower you through our Passion For Protection. Please complete the application below for consideration of a full or partial grant from Divas In Defense to supplement our fee for a self-defense class/workshop.

Full Name:

First Name


Last Name

Email:

ex: myname@example.com

Phone Number:

ex: (555) 555-5555

Address 1:


Street Address

Address 2:


(Apt., Suite, Box, Unit, etc.)

City:
State:

Zip Code:

DOB:

Month

Day

Year

EIN or Tax ID:


ex. xx-xxxxxxx

Social media presence and handle(s):

Facebook:
Instagram:
Snapchat:
Twitter:

Why do you need a grant?

Do you have a budget?

If Yes, what is it?

$

What class/workshop are you looking to attend?

By typing your name below, you authorize Divas In Defense Inc. to review your application and social media platforms.

Electronic Signature:

UA-60998580-1