Steering Committee Précis
Agency Name
Agency Address
Director's Name
Project Name
Phone Number
# total clients for project/
# DCHD clients for
All Clients:
DCHD Clients:
Cost per Unit of Service All Units:
DCHD Units:
Number of Years Agency
has been funded by
Number of years Project has
been funded by CD to date
Amount Requested: Total Project Budget:
Past Performance: To be completed by Community Development
Awarded Amount: Actual Expensed: DCHD Clients Goal:
Actual Clients:
DCHD Units Goal:
Actual Units:
Project Description:
Outcome Statement:
Attach: Income Summary, Expense Summary, Salaries, Benefits, Partners,
Occupancy/Equipment and Supplemental budget pages from your proposal.