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Contact Information <br /> 501(c)(3)'Nonprofit Organization Contact Information <br /> If you are applying with a fi scai sponsor,the information provided in this section should correspond to the 501(c)(3)nonprofit organization,as <br /> they wit be the legal or;aritee. <br /> . ..............................................................:........................................................................................................................................................................................................................................................................................................................ <br /> 501(c)(3)Nonprofit Organization Name(As It Appears on IRS Forms)* <br /> Adventure Centers Hawaii Inc. <br /> 501(c)(3)Nonprofit Organization Mailing Address* <br /> Street Address <br /> 477A Naniakea St <br /> Address Line 2 <br /> City State I Province/Region <br /> Hilo HI <br /> Postal/Zip Code Country <br /> 96720 USA <br /> 501(c)(3)Nonprofit Organization Physical Address(if different from above) <br /> Street Address <br /> Address Line 2 <br /> Cty State f Provnce/Region <br /> Postal f Zip Code Country <br /> 501(c)(3) Nonprofit Organization Director <br /> Title* Suffix <br /> Chair <br /> First Name* Last Name* <br /> Donna Nichols <br /> Contact Person for Grant Correspondence <br /> This person will be the primary point of contact for ail communication related to this grant proposal and award.if the application is through a <br /> 501(c)(3)fiscal sponsor,provide the contact person forth;;;projecttpregram. <br /> Title* Suffix • <br /> Chair <br /> First_Name* Last Name* <br /> Donna Nichols <br /> Phone Number for Contact Person for Grant Email Address for Contact Person for Grant <br /> Correspondence* Correspondence* <br /> (619)405-3900 adventurecentershi@gmail.com <br /> 8.Are you serving as a 501(c)(3)fiscal sponsor for this application?* <br /> Yes No <br /> Adventure Centers Hawaii Inc.-Climbing for Keiki <br />