Leadership Action - Project Proposal Submission

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* 1. CONTACT INFORMATION

Name of Organization or Individual Submitting Project Idea

Primary Contact Name

Organization Address

Email

Phone

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* 2. ORGANIZATIONAL INFORMATION (if applicable)
Provide the mission, purpose and values of your organization.
Briefly describe your organization’s services.

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* 3. PROJECT INFORMATION

Name of Project

Description of Project

Briefly describe the problem or opportunity in our region that this project addresses.

What are your main goals with this project? What does success look like?

How will this project benefit you or your organization?

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* 4. Are you aware of similar projects or initiatives we could learn from?

Yes

No

If yes, which project(s)?

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* 5. Are there additional organizations you would anticipate being involved?

Yes

No

If yes, which organization(s)?

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* 6. We ask that the organization provide 1-2 primary contacts for the Leadership Action group to work with the group from October 2017-May 2018. This will include possible site visits, meetings to fully understand the project and ongoing communication as needed. Will your organization be able to provide the necessary contact and support?

Yes

No

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* 7. As the Leadership Action Team goes through the process to learn more about the community need and the project, the initial intended project and outcome may shift or adjust throughout the process. Is your organization able to be flexible based on the team’s findings?

Yes

No

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* 8. Are you aware that the primary goal of the Leadership Action Team is not to be a fundraiser?

Yes

No