Name of organization check should be made payable to: __________________________________________________________________________ Address check should be sent to: ___________________________________________________________________________ DUNS number for organization that will be receiving the check: ___________________________________________________________________________ Note: if you have questions about DUNS numbers please visit www.dnb.com for more information Program Budget Summary Please be sure to complete this form AND fill in the budget explanatory narrative in the following section. Incomplete applications will NOT be given consideration. What is the annual budget of the applicant organization? Under $50,000 per year___ $50,000-100,000 per year____ More than $100,000 per year____ Projected Expenditures MHC Grant Funds Cash Match Expenditures In-Kind Matching Contributions of Goods and Services Administration ---------------NA------------ Project Director Secretary Fiscal agent Other Honoraria Travel Transportation Meals Office Telephone Duplication Supplies Postage Office Space Equipment Other Program Facilities Meeting space
Name of organization check should be made payable to: __________________________________________________________________________ Address check should be sent to: ___________________________________________________________________________ DUNS number for organization that will be receiving the check: ___________________________________________________________________________ Note: if you have questions about DUNS numbers please visit www.dnb.com for more information Program Budget Summary Please be sure to complete this form AND fill in the budget explanatory narrative in the following section. Incomplete applications will NOT be given consideration. What is the annual budget of the applicant organization? Under $50,000 per year___ $50,000-100,000 per year____ More than $100,000 per year____ Projected Expenditures MHC Grant Funds Cash Match Expenditures In-Kind Matching Contributions of Goods and Services Administration Project Director ---------------NA------------ Secretary Fiscal agent Other Honoraria Travel Transportation Meals Office Telephone Duplication Supplies Postage Office Space Equipment Other Program Facilities Meeting space
Grant_Application_2017-5.docx