Letter of Support Request Form
Congresswoman Scholten's Letter of Support Request Form
Required fields are followed by
*
.
Contact Information
Prefix:
*
First Name:
*
Last Name:
*
Suffix:
Email Address:
*
Street Address:
*
Street Address: (Continued)
City:
*
State:
*
--- Please Select One ---
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
FM
GU
MH
MP
PR
VI
AS
Zip Code:
*
Phone Number:
*
Funding Information
Name of Organization/Group:
*
By what date is the support letter needed?
*
What is the project or issue for which you are requesting support?:
*
Please provide the letter recipient name and address:
*
Title of Grant/Funding Number:
*
What is the exact funding amount you are requesting? (if applicable):
Background Information
Background:
*
Brief Background Information (upload option):
Why is this organization or entity best positioned to be the recipient of these grant funds?:
*
How will this project specifically benefit Michigan's 3rd Congressional District? (if applicable):
Do you have any relevant stats or news stories demonstrating the need for this project?:
*
Any additional information you'd like to share?: