Early Literacy Grant Application

APPLICANT INFORMATION

name of Applicant Organization:

Address:

Phone: Email:

Program Contact Person:	Federal ID #:

PROGRAM INFORMATION

Name of Project:

This project is evidence or research based: ☐ Yes ☐ No

Project Abstract (Describe the early literacy program you plan to provide, pertinent timeframes, anticipated number of children 0-5 and families that you expect to serve, etc.)

How will you publicize the program/event(s) (List/Describe how you plan to advertise to the public and what local entities you share the information to assist in spreading the word.)

Budget

Expense Description	Amount Requested From LFC	Other Funding Sources
$0.00	$0.00
$0.00	$0.00
$0.00	$0.00
$0.00	$0.00
$0.00	$0.00
$0.00	$0.00
TOTAL	$0.00	$0.00

CERTIFICATION

I certify that I am duly authorized to commit assurances for the applicant, and therefore agree to comply with all the provisions of the Early Literacy Grant Application and data requirements, and to the best of my knowledge, the information contained in this application is correct and complete.

Signature of authorized agency person

Title:	Date: