Letter of Intent
Organization Name
*
Enter Legal Name of the Organization and/or DBA
Contact Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Would you like to receive updates to this email?
Yes
No
Website URL
(If applicable)
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Geographic Area Served
Boston
California
Connecticut
Florida (South)
Maryland
New Jersey
New York
Pennsylvania
Reno
Tahoe
Virginia (North)
Washington D.C.
Total Organizational Budget for Current Year
Total Number of People Served Yearly by Organization
Program/Project Name
Project Budget
Funds Requested
Amount of funds you are seeking from NBO
Number of People Served Yearly by Program
Number of people served by the program you are requesting funding for
Demographics
0/500
Additional Comments
0/250
Please verify that you are human
*
Submit
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