Response

Personal Information

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip:

Phone:

Title:

Organization:

Email:

Agency Recipient Info - To whom is this letter being addressed to?

Letter Information

If yes, please specify:

Sen. Catherine Cortez Masto	Rep. Dina Titus
Rep. Susie Lee	Rep. Mark Amodei
Rep. Steven Horsford

Note: If you are a 501(c)3 organization, please attach proof of your tax exemption status to your submission at the bottom of this page.

Grant Information

Provide a brief explanation of the grant and how the funding will be used by your organization:

Provide a description of any support this project has received from the community (If not applicable, please enter "N/A"):

Describe any special circumstances (i.e. time constraints, pressing concerns, etc.) or anything else we may need to know about your program or this grant application (If not applicable, please enter "N/A"):

Please attach a draft letter below, as well as any other documents you feel may be useful to our office in advocating on your behalf. In the letter, describe what your organization does, the purpose of your project proposal, what the funding will be used for, and how the funding will have a positive impact for your community.

Note: Please attach files in .pdf or .docx format

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Letter of Support Request