Hunger Relief Grant Submission Form

Thank you in advance for supporting Central Indiana hunger relief efforts.

If you have any questions about this form, please contact Jennifer Turner, Vice President of Philanthropy, or Robin Elmerick, Senior Director of Effective Philanthropy.

Hunger Relief Donor Grant Form

Fund/Organization To Support

Central Indiana Food Relief Fund (managed by United Way of Central Indiana)

Directly to: Gleaners Food Bank of Indiana, Inc. (EIN: 35-1483868)

Directly to: Hamilton County Harvest Food Bank (EIN: 30-0640307)

Directly to: Midwest Food Bank Indianapolis (EIN: 41-2120170)

Directly to: Second Helpings, Inc. (EIN: 35-1484281)

I would like my philanthropic advisor to contact me to discuss additional options for supporting food insecurity.

If you donate to one of the organizations directly, the Grant Purpose will be listed as "Supporting Central Indiana Hunger Relief efforts" unless otherwise stated below.

Your Fund Name

Enter the name of the specific donor-advised fund you would like to grant from.

Donor Name

First Name

Last Name

Donor Email Address

Enter Email Address

Confirm Donor Email Address

Confirm Email Addres

Grant Amount

Enter the dollar amount you would like to grant to the organization/fund listed above. The minimum grant amount for donor-advised funds is $100.

Any Other Information You’d Like Included with This Grant? (Optional)

Examples: a note that the grant is in honor or memory of someone, or a specific contact person at the organization you’d like us to reference.

Charitable Intent Certification

I certify that this grant recommendation is solely for charitable purposes, and that neither I nor any related party will receive any goods, services, or other personal benefit in exchange for this grant.

If you are human, leave this field blank.