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OMB NO. 0970-0359 Expires: 02/28/09
ATTACHMENT A – Letter of Intent Template
[Applicant Letterhead]
[Date]
To Children's Bureau Regional Program Manager:
________________ (Name of Tribe) plans to apply to operate a title IV-E program beginning in Federal fiscal year (FFY) ________________.
The intended Tribal service area is:_____________________________ and the intended population to be served is __________________________________________________.
_____ We plan to apply for a one-time development grant of up to $300,000 in FFY ______.
_____ At this time, we do not plan to apply for a one-time development grant.
Contact information
Name:
Date:
Position:
Tribe or Organization:
Address:
City/State/Zip:
Phone:
Fax:
E-mail:
