PLEASE PRINT

Project coordinator

• Name: _____________________________________________________________
  
  
• E-mail: _____________________________________________________________
  
  
• Street: _____________________________________________________________
  
  
• City: _________________________ State: _____________ ZIP: _______________
  
  
• Phone:
  Home: _________________ Work: ________________
  
  Cell: ___________________ Fax: _________________
  
  
• Are you 18 or older?   Yes: ____     No: ____
        If no, what is your age? ____

Group information if this is a group proposal

• Group's name: __________________________________________________________
  
  
• Type of group:
     School: Elementary ____   Middle ____   High ____
  
     College/University ____   Church ____   Business ____   Organization ____
  
     Other (describe): ___________________________________________
  
  
• How many are in your group? ________

Project information

• When do you plan to do this project? ________________________________________
  (provide start and end dates if that is appropriate)
  
  
• Proposed location of project:
  
  
  
• What is your goal?
  
  
  
  
• Provide a detailed description of the proposed project:
  
  
  
  
  
  
  
  
  
  
• Describe how you plan to promote the project:
  
  
  
  
  
  
  
  
  
  

Please send the completed form to Carlin Christy, Education Coordinator, at Homeless Children's Education Fund, 2100 Smallman Street, 2nd Floor, Pittsburgh, PA 15222 or fax to 412-562-1109. If you have questions or would like more information, call 412-562-0154.

We recognize this proposal as an expression of your support of and confidence in HCEF's ability to bring "Hope Through Learning" to children whose families are homeless in Allegheny County. We are most grateful and will be in touch with you after we have reviewed the proposal.

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