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Application Form (to be formatted into a fillable PDF file) <br />PROPOSAL INFORMATION <br /> <br />Total Request: <br /> <br />APPLICANT INFORMATION <br /> <br />Name of Applicant Organization: <br /> <br />Mailing Address: <br /> <br />City, State, Zip: <br /> <br />Phone: <br /> <br />Fax: <br /> <br />Email Address: <br /> <br />Website: <br /> <br />Federal Tax Identification Number: <br /> <br />Type of Organization: <br /> Government <br /> Non-Profit <br /> For-Profit <br /> Other (please specify): <br /> <br />PROJECT CONTACTS <br /> <br />Name of Organization Director: <br /> <br />Phone: <br /> <br />Email: <br /> <br /> <br />Project Contact Name: <br /> <br />Title: <br /> <br />Phone: