IL-EATS - Appendix E - Contact Information Template

Complete one copy for Applicant organization.

  • Organization Name:
  • FEIN:
  • Street Address:
  • City:
  • State:
  • IL-EATS Region:
  • IL-EATS Counties to Be Served:
  • For Cook County, applicants must also provide the zip codes they propose to serve with the requested funding:
  • Executive Director:
  • Street Address:
  • City:
  • State:
  • Phone:
  • Email:
  • Program Director:
  • Street Address:
  • City:
  • State:
  • Phone:
  • Email:
  • Fiscal Contact:
  • Street Address:
  • City:
  • State:
  • Phone:
  • Email: