Letter of Intent Submission

Please fill out ALL sections. This is to be used for FY2013 Maryland Heritage Areas Authority Project grants only.

*(denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

Applicant Organization: *

Street Address: *

City: *

Zip: *

Type of Project (Pick one)

Capital
Non Capital

If Capital, what Target Investment Zone:

Project Title: *

Description: *

Budget Amount Requested: *

Budget Cash Match: *

Budget In-Kind Match: *

Total Project Cost: *

Additional Notes:

CAPTCHA Code: *