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(RFF)Request for Funds Form

Company Name

Requestor Contact Full Name

Phone

Email

Please describe overall and general reason for funds. A detail description for each item is required until later on on the form.

You may submit up to 2 Invoices per form. Please fill out additional forms for request beyond 2 invoices, proof of purchases.

Request #1

Pre-purchase or reimbursement*

Item description

Invoice or Proof of Purchase

Request #2

Pre-purchase or reimbursement*

Item description

Invoice or Proof of Purchase

Total Amount

Any additional information?

Signature

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San Joaquin Juneteenth Foundation

943 North El Dorado Street

Stockton, CA 95202

Contact Us:

info@stocktonjuneteenth.org

(209) 457-SJJF (7553)

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© 2025 by San Joaquin Juneteenth Foundation Inc. 501(c)(3).

The San Joaquin Juneteenth Foundation is a non-profit 501c3 organization, Tax ID number is 82-2939889.

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