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Please complete and submit this form and email the requested documents at your earliest convenience.

Please email the following documents as attachments to TTP_Admin@itnamerica.org: (Required)

TTPs Form

Organization(Required)

Please confirm that your organization is currently classified by the IRS as a tax-exempt 501(c)(3) charitable nonprofit(Required)

Yes

Do you screen volunteer and paid drivers?(Required)

Yes, with criminal background checks

Yes, with driving history checks

Yes, with both criminal and driving history checks

No, we do not

Please share the name of the service you use to screen drivers(Required)

Please confirm your mailing address to ensure smooth delivery of quarterly eye care checks(Required)

Street Address Address Line 2 City State Zip Code

Who will serve as the primary contact person for the TTP grant this year?(Required)

First Name Last Name

Email(Required)

Phone(Required)

Position(Required)