Name, Title, Phone Number, and email address of Executive Director/CEO *
Your answer
Dollar amount of this funding request *
Your answer
Total project budget *
Your answer
Period this funding request will cover
Your answer
Purpose of this funding request, including brief description of the population and number of individuals served, and geographic area(s) that will benefit (as applicable) *
Your answer
What problem or need does your project address? *
Your answer
What is your proposed solution to this project or need? *
Your answer
Are there additional partners who you are working with for this project? If so, who are they and what are their roles?
Your answer
What results are you committed to achieving during the grant period? What is the timeline for accomplishing these results? What evidence will prove your success?