United Way of Eastern Maine Community Investment Letter of Intent
For the funding period of July 1, 2019 - June 30, 2022.

This form is REQUIRED for all applicants. Please complete a separate form for each program you will be applying for.

Email address *
1. Contact Information
Agency Name
Your answer
Program Name
Your answer
Physical Address
Your answer
Mailing Address
Your answer
Phone
Your answer
Fax
Your answer
Agency Executive Director
Your answer
Executive Director Email
Your answer
Executive Director Phone
Your answer
Program Director (Name and Title)
Your answer
Program Director Email
Your answer
Program Director Phone
Your answer
Please list any other agency or program contacts (Name, title, email, and phone)
Your answer
1. Please provide a brief description of your program.
Your answer
2. Using the Opportunity 2028 Measurement Framework, which Goal will you be applying under?
3. Do you meet the eligibility requirements as outlined in the FY 20-22 Community Investment Overview?
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service