Please enable JavaScript in your browser to complete this form.Grantee *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Additional Staff EmailAdditional Staff Email Phone *Website / URL *Number of People Impacted By This Grant *Please Add DetailPlease Upload A Detailed Spreadsheet Of Lenz Foundation Grant Expenditures * Click or drag files to this area to upload. You can upload up to 5 files. Please List, Individually, Each Fund Category and ExpenditureHas The Grant Met It's Goals *Have You Experienced Any Program Implementation Difficulties *Have You Received Any Recent News Coverage *Were You Able to Utilize Dr. Lenz's Materials In Your Program *Have There Been Any Organizational Changes Since Your Grant Was Implemented *Please Include Any New Lenz Contacts And Their InformationOther Relevant InformationAdditional File Uploads Click or drag files to this area to upload. You can upload up to 6 files. Submit