NORTHEAST WILDLIFE DAMAGE MANAGEMENT COOPERATIVE
Project Application Form
1. Please fill out all information completely. Failure to do so may result in a reduced
rating or disqualification of your proposal.
2. Please type all information.
Part A - APPLICANT INFORMATION
Type of Applicant (please choose appropriate designation)
; Government Agency/Organization
; Private Agency Organization
; Educational Institution
Please list the names and titles of all key personnel involved in your project
Part B - GENERAL PROJECT INFORMATION
1. Title of Project
2. Type of Project
3. Please describe the purpose of your project in 25 words or less.
4. What is the proposed timeline for your project?
5. What deliverables do you expect as an outcome of this project?
Part C - PROJECT COST – 2007 PROPOSED BUDGET
Total Project Cost: $_________________
Grant Funds Requested $_________________
Applicant Match $_________________
Please list the sources and the amount of applicant match:
Project Title: _____________________________________________________________________
Expenditure Category Grant Funds Cash In-Kind Total
Salaries and Wages $ $ $ $
Travel (at State rates)
Supplies and Materials
Indirect Costs (20.0%)
TOTAL $ $ $ $
Please attach budget justification if necessary
Part D – PROJECT DETAILS
1. What is the need, problem, or opportunity that the project addresses?
2. How does the proposed project resolve the problem/need or capitalize on the
opportunity identified in this project?
3. How does the applicant plan to carry out the project? (Describe the timeline and
4. How will the project when implemented benefit one or more of the States in the