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Support for Health Sciences Librarians to Carry Out AIDS Outreach in the Pacific Northwest

Application Form

Name of Library:

Institution:

Address:

Telephone:

Fax:

E-mail Address

Have you had experience using Grateful Med? Yes/No

Is your library a member of the National Network of Libraries of Medicine? Yes/No

Total amount of money requested: $

Required Attachments

Describe your proposed project, including names of potential AIDS organizations to be contacted (e.g., AIDS Caregivers Support Network); type and size of the audience (e.g., 10 school nurses who do prevention training in high schools); and a description o f how you intend to enable your audience to obtain information (e.g., the training process you might use). This part of your proposal does not need to be longer than 1 page.

Submit a line-item budget, giving broad categories (e.g., travel, equipment rental) and the total.

Two letters must be included: a letter of support from the employing institution and a letter from at least one of the AIDS organizations or individuals with which the applicant proposes to work, showing the organization�s or individual�s willingness to p articipate in the project.