Letter of Support Request Form

Please answer the following questions and submit the completed form. (All Fields Are Required)
You must type directly into the boxes. Do not cut and paste text from another document.
Please do not navigate away from this page until you have pressed Submit Request as you may lose all data entered.
Please wait for a message stating that your request has been submitted before navigating away from this page.

NOTE: This form works best under Internet Explorer 5.5 or greater. If you are having problems with submitting the online form, please email the webmaster@co.broome.ny.us or call 607.778.8057 during regular business hours.

Broome County Human Services Letter of Support Request Form

Please answer the following questions and submit the completed form. (All Fields Are Required)
Please do not navigate away from this page until you have pressed Submit Request as you may lose all data entered.

Guidelines For Seeking A Letter of Support

Grant Information

(eg. DHHS, OCFS, private foundation name, etc.)

Contact Information
Request Information
County department(s) from which you are seeking a letter of support from

(Choose Required or Requested or leave as None if not seeking from this department)

(target population, target area, program capacity, etc.)

Please answer to the best of your knowledge.


Footer