Recommendation (from who)____________________________________________________________________

NAME of Organization_________________________ TYPE of Organization_______________________________

ADDRESS _______________________________|___________________|____________________|_____________|________      (number, street)                                            (city)                                    (state)                           (country)              (zip)

PHONE # (office)__________________________ (message)____________ (fax) ______________e-MAIL_________

PRODUCT or SERVICE__________________________________________________________________________

______________________________________________________________________________________________

CAPITAL :_____________________________________________________________________________________

INCOME______________________________________________________________________________________

HUMAN RESOURCE ____________________________________________________________________________

______________________________________________________________________________________________

WHY YOUR ORGANIZATION BETTER  THEN OTHER SIMILAR _______________________________________

______________________________________________________________________________________________

ACHIEVEMENTS: _____________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

 Applicant's Signature __________________ Date _______________________________