SFY 23 Capital Investment Grant Application

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* 1. Organizational information

Organization Legal Name

Street Address

City

State

ZIP code

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* 2. Project Director information

Project Director *

Title *

Phone number

Email Address

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* 3. Tier Level

Tier 1 ($5,000 - $19,999)

Tier 2 ($20,000 - $40,000)

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* 4. Projected Project Completion Month

December 2022

January 2023

February 2023

March 2023

April 2023

May 2023

June 2023