Pre-Request Form

Pre-Request Form

Contact Name(Required)
Does the proposed project serve people in Wayne, Oakland and/or Macomb Counties?(Required)
*Please note that requests made under the Health of Metropolitan Detroit priority areas are only eligible for 1 or 2 year grants.
This field is hidden when viewing the form
Have you defined an evaluation plan and a sustainability plan?
In the File Upload box below please submit:
  1. Completed project budget (see link to download form above)
  2. Organizational budget
  3. IRS Tax Exemption Letter
Drop files here or
Accepted file types: jpg, gif, png, pdf, doc, docx, xls, xlsx, csv, Max. file size: 15 MB.