COVER SUMMARY FOR ALL GRANT PROPOSALS

Date:

1. Legal name of organization, address, and name of executive director

2. Contact person for this grant request:

3. Amount requested:

4. Please name other organizations where funding has been requested:

5. Summarize the proposal request and its link with GBCA:

6. Name the proposal's target population, constituents and geographic communities:

7. Name ways to measure program success:

8. Total annual organizational budget: $_____________ Fiscal Year End

9. The period this grant will cover:

10. United Way affiliate: yes no

Grant proposals should be sent to:
Martha J. Curtis, RN, LICSW, BCD,
P.O. Box 470828,
Brookline Village, MA, 02445.