Proposal Cover Sheet Form

I have read the reporting expectations and agree: www.lifeinternational.com/grantreporting *

Yes

Date of Application *

Date of Application

YYYY

Legal name of organization applying *

Name should be the same as legal NGO filing

Year Founded *

Current Operation Budget *

Monthly

Annual

Executive Director *

Telephone Number *

Contact Person / Title / Telephone Number

If different from Executive Director

Email Address *

Street Address of Principle or Administrative Office *

City *

State or Province *

Postal Code *

Country *

Fax Number

List any previous support from this funder in the last 5 years. *

Project Name *

Purpose of Grant *

One sentence

Dates of Project *

Amount Requested *

Total Project Cost *

Geographic Area Served *

* required field(s)