Submitting a Proposal
Please fill out the below coversheet and upload your proposal by November 12, 2019 at 8 p.m. EST. If multiple organizations are submitting a proposal together, each should complete a separate coversheet. 
 
Should you have any questions or concerns about using this form, please contact Winnie Ye at wye@nirhealth.org for assistance. 

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* 1. Proposal Title

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* 2. Project Category

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* 3. Funding Amount Requested

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* 4. Legal Name of Organization
If your proposal is selected, this is the name the check will be made out to.

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* 5. Public-facing Name of Organization (if different)

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* 6. Projected 2020 Organizational Budget

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* 7. Projected 2020 Project Budget, if applicable
Please include if the amount exceeds funding requested from NIRH.

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* 8. Employer Identification Number (EIN)

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* 9. Mailing Address

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* 10. Street Address (if different)

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* 11. Primary Contact for Management of Initiative
This should be the person who will be working most closely with NIRH on the project, if funded.

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* 12. Primary Contact for Management of Funding and Reporting (if different)
This should be the person who will be managing the financial process with NIRH, if funded.

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* 13. Project Summary
Please provide 2-3 sentences summarizing your project. Feel free to pull from your executive summary in your proposal.

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* 14. Are you partnering with an organization or multiple organizations on this initiative?
If yes, please list the names of the organizations in the box below. Only one organization needs to upload a copy of the proposal.

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* 15. Please upload your proposal. 
  • Include the name of your organization and your proposal title in the header of your proposal and please save the file name with the following template: Organization Name_NIRHLocalProposal_Date.
  • If you are submitting a proposal with multiple organizations, only one organizations needs to upload the proposal and all organizations must submit a coversheet.
If you prefer to email your proposal, please email it to Winnie Ye at wye@nirhealth.org.

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