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          <FormAndInfoAndMaterialsTxt>THE APPLICATION SHOULD BE IN WRITING STATING THE PURPOSE OF THE ORGANIZATION, ADDRESS, TELEPHONE NUMBER AND PERSON TO CONTACT. ALSO PLEASE INCLUDE PRIOR PERIOD OPERATING STATEMENT AND BALANCE SHEET, AND WHETHER THE ORGANIZATION IS A 501(C)(3) ORGANIZATION.</FormAndInfoAndMaterialsTxt>
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            <ZIPCd>87154</ZIPCd>
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          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PUBLIC CHARITY</RecipientFoundationStatusTxt>
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        <GrantOrContributionPdDurYrGrp>
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            <StateAbbreviationCd>NY</StateAbbreviationCd>
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          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PUBLIC CHARITY</RecipientFoundationStatusTxt>
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        <GrantOrContributionPdDurYrGrp>
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            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>06902</ZIPCd>
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          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
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          <GrantOrContributionPurposeTxt>EDUCATION</GrantOrContributionPurposeTxt>
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        <GrantOrContributionPdDurYrGrp>
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            <BusinessNameLine1Txt>DUKE UNIVERSITY</BusinessNameLine1Txt>
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          <RecipientUSAddress>
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            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>90581</ZIPCd>
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          <RecipientRelationshipTxt>NONE</RecipientRelationshipTxt>
          <RecipientFoundationStatusTxt>PUBLIC CHARITY</RecipientFoundationStatusTxt>
          <GrantOrContributionPurposeTxt>MEDICAL, EDUCATION AND SOCIAL SERVICES.</GrantOrContributionPurposeTxt>
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        <GrantOrContributionPdDurYrGrp>
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            <BusinessNameLine1Txt>IMENTOR</BusinessNameLine1Txt>
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