Support Letter Request Form

Thank you for contacting Congressman Gottheimer's office to request a letter of support for your grant application.

If you have any questions, please call the Congressman's Return on Investment Director at (201) 389-1109.

Name and Title of Organization Contact*

Organization*

Organization's Address*

Street 1 Street 2 City State Zip

Email Address*

Phone* () -

Federal Agency Name*

Agency's Grant Program Title

CFDA Number*

Name and title of support letter addressee (normally found in application guidelines)*

Mailing Address of Agency*

How would you like the support letter delivered? * Mailed to the agency.
Emailed to you as a pdf

Name of your project/program*

Granting Agency Application Deadline*

In-House Deadline*

Amount of funding you are requesting*

From whom, in addition to Congressman Gottheimer, have you requested support letters? *

From whom have you received support letters? *

Paste here a one page project summary. Including: 1) What your organization does and who it serves. 2) What the project does and who it benefits (geographically, number of people, demographically) 3) List any partners/collaborators who are involved with the project. 4) Specifically how will the grant money be used?