State of New Jersey Department of Children and Families
State of New Jersey
Department of Children and Families
Proposal Cover Sheet
Please complete this form in its entirety
Incorporated Name of Applicant:
Public Private-for-Profit Private-Non-Profit
Enter X as appropriate
Federal ID No.: Charitable Registration No.: DUNS #:
(if applicable)
Applicant Mailing Address:
Contact Person:
Phone Number: Fax: Email:
Title of RFP:
County to be Served:
Location of Service(s) to be provided (if known):
Total dollar amount requested:
Funding Period: From to
Brief description of services by program name and type of service to be provided:
Authorization
Chief Executive Officer:
Signature: __________________________________ Date: _____________
CEO Email: __________________________________
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