Letter of Intent Directions Please email the completed Letter of Intent to Michelle Brown at

mbrown@daytonfoundation.org in Word format by 4:00 p.m. on the deadline date. Incomplete or late proposals will not be reviewed during the current cycle. Your answers are limited to the space provided. Please use an 11 point font, and do

not alter the format of this application. Required documents must be postmarked on or before midnight of the deadline date, or hand

delivered by 4:00 p.m. of the deadline date. Required documentation cannot be faxed or e-mailed.

Please mail the following documentation to The Dayton Foundation:1. IRS letter of determination 501(c)(3)2. Names of your organization's board members, terms of office and compensation, if any. 3. List of key staff members and your organizational chart. 4. One example of each of the following (if available):

a. Annual Report b. Organizational brochurec. Newsletter

5. A balance sheet and income statement covering your organization's most recently completed fiscal year.

Please mail all of the documentation to:The Dayton Foundation Grants and Programs Department40 N. Main Street, Suite 500Dayton, Ohio, 45423

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The Dayton Foundation - Letter of IntentGENERAL INFORMATION (all fields required)Organization's Name:Federal Tax ID#:Mailing Address:City: State: Zip

Code:Daytime Telephone:Web Site Address:☐ Executive Director/ ☐ CEO's Name (check one):Executive Director/CEO's E-mail Address:

Organization's Current Budget: $Project/Program Budget: $

Requested Grant Amount: $Contact Name for Grant Application:Title:Daytime Telephone:E-mail Address:State the purpose of your proposal/request in no more than two sentences:

What is the program area that best applies to this proposal (check one):Arts & Culture HealthEnvironment/Animals Human ServicesEducation & Youth Development Public/Society Benefit

Grant Category:

☐ Capacity Building ☐ Capital Campaign or Capital Improvement ☐ Special Project or Program Expansion

TERMS AND CONDITIONS

Letters of Intent must be submitted only as an e-mail attachment. I hereby certify that, to the best of my knowledge, all information presented in connection with this Letter of Intent is accurate. I agree to, and fully understand, this Letter of Intent form, and I have reviewed the Dayton Foundation's Guidelines for Competitive Grants, and I accept its terms and conditions.

Executive Director/CEO’s Signature Date

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PROJECT SUMMARYTitle of Project/Program:

Please summarize your proposal, including brief, but specific information including: the purpose and need, how it will work, who it will serve (including number of clients and geographical area), costs involved, and a timetable for implementation of the project.

Your project summary must not exceed 3,000 characters in length (spaces count as characters). Please use an 11 point font.

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