Letter of Intent (LOI) Web Site Proposal Summary Project Name * Amount Requested * Project Budget * Organization Budget * Brief Project Description * Maximum 500 characters Project Duration * Please tell us how long the project will last. Be specific, (e.g. days, weeks, months...) Project Type * A new project An ongoing project Please specify what kind of project the funds are intended for. Type of Support Requested Request Type * General operating support Program/Project support Start-up costs Capital Endowment Technical Assistance Other If Other, please specify Priority Area * Education Children Health & Human Services Arts & Humanity Seed Funding in Capital Expense to Enhance Program Other If Other, please specify Organization Information Organization Name * The legal name of the organization Tax ID # * Contact Address * Contact Address Line 2 City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana IAIowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Salutation Mr./Ms./Dr., etc. First Name * Last Name * Title * Telephone * Fax Email * Communication regarding your approval status will be sent via email. Please make sure your email address is correct. Website Address Optional Organization Description *
