Letters of Intent due Friday, April 7, 2017 by 11:59 pm.

Please complete the information requested below to indicate your intention to apply for the School Health Professional Grant.(Required.)

Name of LEA (District)/BOCES:

Applying on behalf of the following school(s):

Name of LEA/BOCES Authorized Representative:

Name of Contact for the Proposal:

Contact Telephone Number:

Contact E-mail Address:

Anticipated Amount of Funds to Request (If known):

I affirm that I am the named authorized representative from the LEA/BOCES, or that the named authorized representative is aware and has approved of the intent to apply for the grant opportunity.(Required.)

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