Our Neighborhood Athlete - Dance Troupe Funding Registration form Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### Email * Part 2 Name ( Of 2nd Leader ) 2nd Leader in command First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Email Part 3 How many members? * How many that are on the team or in the group? Give a detail about your group or team Give us a brief details about you and group or team and why this is so important to you, your group or team, and the community. Account Information Amount Requesting * Amount requesting after fundraising accounted for: $ How would you like to receive your funding? * A secure Bank Account : Note: Cash App is not accepted. Bank Account: Zelle: PayPal: Venmo Fundraising for * Basketball Football Baseball Soccer Tennis Dance Other Subject Message Thank you!