SAMPLE COVER PAGE FOR GRANT PROPOSAL - Breast Cancer …



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INDIANA BREAST CANCER AWARENESS TRUST, INC.

Patient Services - Screening & Diagnostic Grant Program

The mission of the Indiana Breast Cancer Awareness Trust, Inc. (IBCAT) is to increase awareness and improve access to breast cancer screening, diagnosis and support services throughout Indiana. IBCAT receives funds through sales of breast cancer awareness specialty license plate. Indiana Breast Cancer Awareness Trust plate sales began in January of 2002.

Through these sales, monies are available for grants deemed to best address the unmet breast health/cancer needs of the people of Indiana. Each Indiana Breast Cancer Awareness plate sold generates a $25.00 donation. The Indiana Breast Cancer Awareness Trust is a 501(C) 3 Not for Profit organization incorporated in the State of Indiana.

| Grant Guidelines |

• Project must be specific to providing breast cancer screening and diagnostic services to lower income, medically underserved Hoosier women.

• Grant request limit are outlined within the application.

• Organizations may only apply for one (1) screening/diagnostic grant annually.

• Reimbursement rates are based on the current Medicare rates. (See Budget Form for rates.)

• Funding will be limited to expenses as stated on the Budget Form page. No personnel or indirect expenses will be covered by the grant program and should not be included in your application.

• If your organization is not the direct provider for mammography services, a Letter of Agreement must be included from the service provider. This letter must state agreement to accept the IBCAT reimbursement rate as outlined above.

• Applicants must be a 501(c)3 or federally tax-exempt entity.

• Services are to be within the State of Indiana and for only for Indiana residents.

• A grant contract will be the legal mechanism for funding of grant.

• Grantees will submit a six-month progress report as well as a final grant report to IBCAT. Quarterly financial reports are also required.

• Announcement of awards will be made no later than December 15, 2020.

• Grant funding for this project will begin January 1, 2021 and end December 31, 2021.

• Grant Applications must be received no later than Friday, October 2, 2020. Late applications will not be accepted for review.

• An electronic copy must be submitted to info@ no later than October 1, 2020.

• Applications must be submitted as stated within the grant application. Applications not submitted in the proper order and/or not including all required information may be rejected.

• Please use United States Postal regular or priority mail service. No certified mail or shipping that require a signature for pick-up. No faxed applications will be accepted.

• Submit one original, plus eight (8) additional copies. All copies should be stapled, and may be duplexed. No binders, folders or paperclips. This is in addition to the electronic copy due as stated above.

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