Initiative Expansion Grant
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Initiative Project Proposal Title:
Initiative Proposal Addresses:
3+ Respite Transportation
1. Contact Information and Organization:
Organization name:
Physical address:
President/CEO:
Grant contact person-direct phone number & email:
Profit/Non-Profit status:
Number of years in relevant business:
Current number of FT & PT employees:
Current hours:
Current capacity:
Disability of clientele served:
PASA sta tus:
Licenses:
Medicaid status:
Current training requirements:
Current mission & vision statements:
2. Goals & Objectives:
What are the underlying needs and conditions that must be addressed? What are the goals and objectives?
Goals and objectives will lead to the long-term outcomes.
3. Proposal Overview/Summary:
Include a brief description that includes what you will do, why and how you are addressing the topic.
