2010-2021 Community Grant Letter of Intent
Susan G. Komen Virginia Blue Ridge
Name and phone number
Provide a brief outline of the proposed program by answering all questions below
Name of applicant organization
Is applicant a non-profit or government organization?
Which funding priorities of the RFA are addressed?
Funding Priority 1
Funding Priority 2
Funding Priority 3
Description of program including services provided (2,500 character limit)
How will proposed program be implemented -- i.e. steps to achieving the program’s goal(s)? (2,500 character limit)
Discuss any partnerships or collaborations in place/to be formed to create a successful project (1,500 character limit)
Target population and/or areas served with estimated numbers of total individuals served and/or services provided (1,000 character limit)
Estimated budget range for total program budget
Less than $10,000
$10,000 - $19,999
$20,000 - $34,999
$35,000 - $50,000
Following the submission of the Letter of Intent, Affiliate staff will provide written feedback on your program proposal within 10 days to assist in the proposal process.
A copy of your responses will be emailed to the address you provided.
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