IMPORTANT NOTES:

1. The system will “time out” after 2 hours of inactivity resulting in a loss of your information.
2. Copy down the Application ID Number that is given when the request is submitted.
3. All correspondence will be by e-mail to the address supplied in the “Applicant Information” section of the grant application. Please ensure that if you are processing this request that you have access to that e-mail account.

The following information is required unless otherwise noted:

Organization Profile: Complete your organization's profile.

• Legal Corporate Name
• Address
• Phone, Fax, Tax ID Number, Tax Status
• Web Address (if available)

Contact Information:

• Project Contact Information
• Alternate Contact Information

Project Description:

• Local or National Project (Local is considered to be counties in Northeast Pennsylvania and the Lehigh Valley; National is considered to be all other areas)
• Project Title
• Program Area (if applicable)
• Budget
• Goal of the request
• Expected Results

Additional Organization and Project Information:

• Mission of your organization
• Population the program/project will reach
• Organizational structure
• Annual budget
• Strategic plans
• Affiliations