Funding Agreement Local Group Leader

Local Group Information

Date

Name of Group Leader

First Name

Last Name

Name of Local Group

Requested funding amount:

Group leader's explanation of how the funding will be utilized:

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Date funds are required:

Where do we send the check when the funds are approved?

Name

First Name

Last Name

Phone

Address

City

State/Province

Zip/Postal

Country

Address

Signature of the group leader signifying their agreement to the terms outlined in the IANDS Affiliated Group Funding Program dated August 17, 2024.

Signature of the group leader:

Clear

Date

Signature of the authorizing board director and group coordinator:

Clear

Date

International Association For Near-Death Studies

2741 Campus Walk Avenue, Building 500 Durham, NC 27705 919-383-7940 www.iands.org

Phone

Local Group Information

Where do we send the check when the funds are approved?

Signature of the group leader signifying their agreement to the terms outlined in the IANDS Affiliated Group Funding Program dated August 17, 2024.

International Association For Near-Death Studies

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