TPSF Emergency Relief/Recovery Funds Request Form

Use of this form is to request funds for emergency relief and recovery efforts conducted by physicians and other child advocacy organizations in Texas during times of a natural disaster such as a hurricane, flood, fire, earthquake and other emergency/disaster events. 

 

 

Please provide a brief paragraph outlining your organization's purpose and mission.
Hospital, Nonprofit Organization, Medical School, etc.
Please give a detailed description on the proposed use of the funds requested.
Please upload a list of current Board of Directors (if applicable)
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc.
Please upload a copy of your organization's IRS Determination Letter (required only for 501 organizations)
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.