Please supply:

1. NARRATIVE (preferred length not to exceed four pages): Include the following information in any order.
   1. Agency Information
      1. Mission statement, brief statement of organization's goals, and/or objectives;
      2. Brief summary of organization's history;
      3. Description of current programs, activities and accomplishments.
   2. Purpose of Grant
      Include the following:
      1. Brief statement of the issue to be addressed; description of the constituency served (include number served); target population; how will they benefit?;
      2. Description of goals and objectives for the purposes of this grant;
      3. Description of activities planned to accomplish these goals; is this a new or ongoing activity on the part of the sponsoring organization?;
      4. Timetable for implementation (if for specific program or capital project);
      5. Other organizations, if any, participating in the activity;
      6. Long term sources/strategies for funding at the end of the grant period;
      7. Strategy for evaluating the program/organizational outcomes.
2. ATTACHMENTS Please attach the following:
   1. Board of Director names, occupations and/or community affiliations;
   2. List of names and qualifications of key staff;
   3. Most recent fiscal year-end financial statements (audited if available);
   4. Current agency budget;
   5. Program/project budget (if applicable);
   6. Annual report; and,
   7. List of major contributors and amounts to organization/program; include in-kind donations.