Grant Letter of Intent

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Please use this form to let us know of your intention to apply for a grant
1. Applicant

	First Name *

	Last Name *

	Organization *

	Phone *	Ext

	E-mail *

2. VHC Grant History

	Yes, we received a VHC grant in the past

	What was the name of the previous grant(s)

3. Proposed Grant Project Details

	Please tell us a little about the project *

	What is the amount you will be requesting? *

	What is the project budget? Indicate the areas VHC would be funding. *



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