This form will provide us with basic information regarding the scope of work in your document preparation.
1. Personal Contact Information
*Contact
First Name:
*Contact Last Name:
*Phone:
*Email:
2. Organization Contact
Information
*Organization Name:
*Your Title:
*Are you authorized to sign documents and enter
into agreements on the organizations' behalf?
Yes
No
*Business Phone:
Business Fax:
Website Address or Domain Name: www.
.com
.net
.biz
.org
.info
other
Organization Email (example: Info@xyz.com):
*Organization
Address:
Suite/Unit:
*City:
*State:
*Zip:
3. Non Profit Category
*Which of the following categories closely describes your organization's
function:
Church
Community or At Risk Youth
Hospital/Medical Research
School/College/University
Personal Care or Similar Home
Other
If "Other" was selected, please describe the organization's category:
Is the organization recognized by the U.S. Treasury Department as a non
profit [501(c)(3)]? Yes
No
4.
Program Information
*Name of Program:
Briefly describe the program (200 words max):
Characters Remaining:
800
Has the program been funded before:
Yes
No
5.
Grant Proposal
Briefly describe your expectations after having received the grant proposal:
Which of the following will receive your grant proposal for consideration:
Corporations
Private Donors
Government
Other
6.
Quote Delivery Preference
*What is your preferred method (s) for
receiving your quote?
Phone
Email
Fax
Please verify the accuracy of Contact Information for quote delivery.
7. Hillman B2 Quote Request Policies
Waiver Agreement.
Please be advised that paying Hillman B2 for document development has no bearing on the final decision made by the
company, person, government or private agency or otherwise that is
receiving your document. The commitment made by Hillman B2 is that we
will properly and professionally prepare the documents based upon
information you submit, and provide them to you for final
submission after payment is received. We make no warrants, claims, or guarantees
regarding the final accomplishment of any document that you submit
to others for review support, funding, approval or any other
consideration. Payment & Cancellation. All Quote
Requests submitted through this website are submitted with no
purchase obligation. In order to receive services, HillmanB2.com website visitors must agree that
after receiving a quote, if a product or service is then ordered,
that full compliance with the terms of our
Payment & Cancellation Policy is required. The policy can be reviewed
here.
8.
Waiver & Form Submission
Agreement with the Hillman B2 Quote Request Policies is required
to process the form. If you do not agree, you may close out this window.
If you agree, proceed forward by selecting the I agree option below:
I
agree.
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