Name

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Address

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Email

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Are you resident of East Hampton, CT?

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Are you a 501(c)3 Organization?

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Are you seeking other funding?

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Purpose: Briefly state the needs or issues to be addressed with this project/program.

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Goals & Objectives: Briefly describe the objectives, how the goals will be achieved, and timeline.

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Assessment: How will you know if the project/program is successful?

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Awareness: Please describe the manner in which you plan to promote/publicize your project and credit EHAcC for funding support.

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