Discretionary Funds Letter of Intent

Please complete the letter of intent form below by 4 p.m. on February 4, 2019, or July 1, 2019.

  • Incomplete or late proposals will not be reviewed during the current cycle.
  • Your answers are limited to the space provided. 
  • Required documents must be emailed on or before the deadline date. 

Please email the following documentation to Premier Health:

  • IRS letter of determination 501(c)(3)
  • Names of your organization's board members, terms of office and compensation, if any. 
  • List of key staff members and your organizational chart. 
  • One example of each of the following (if available): 
    • Annual report 
    • Organizational brochure
    • A balance sheet and income statement covering your organization's most recently completed fiscal year.

Please email all of the documentation to: [email protected]