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2025 Project Diabetes Letter of Intent

Applicant

1. Applicant Information: *This question is required.

Space Cell	Column 1
Organization Name	Organization Name: Column 1
Contact Person	Contact Person: Column 1
Contact Email	Contact Email: Column 1
Confirm email	Confirm email: Column 1
Contact Phone Number	Contact Phone Number: Column 1

2. Select the Grant Category you are applying for. *This question is required.

A - Up to $450,000 for 3 years
B - Up to $30,000 for 2 years

3. Town(s) and County(ies) where your project will be located? *This question is required.