Letter of interest

Grant application

Requests must be between $1,000 and $10,000. Fields marked with an asterisk are required.

Organization

Organization name * Legal name Also known as Mailing address * City * State or region * Postal code * Main phone * Main fax Organization website Employer ID number * Organization tax status *

Proposal

Proposal date * Requested amount * Project title * Project description *Provide a concise description of the proposed work. Total project budget * Project duration * Committed and potential funding sources Geographical area served * Age group served *

Primary contact

Prefix First name * Last name * Title Phone * Email *