Partner Identification From and Cost Share Worksheet*

Please indicate each partner organization and its share of funds provided foe each year of the proposed grant.

All Projects must have at least one lead and one partner organization.

Partner # ___________                                                         Signature _____________________________________

                                                                                                    (signature of Authorizing Official)

Partner: Name/Title __________________________________________________________________________

Institution/Organization _______________________________________________________________________

Department/Faculty __________________________________________________________________________

Address ___________________________________________________________________________________

City _________________________________ State ________________________ Zip _____________________

Telephone ____________________________ e-mail _______________________ Fax ______________________

Type of Institution/Organization _________________________________________________________________

Cost Share Provided by Partner

Year 1

1. Salaries and Wages  
2. Benefits  
3. Travel  
4. Equipment Purchase or Lease  
5. Materials and Supplies  
6. Consultants/Contracts (other than partners)  
Other  
Total Cost Share Provided by Partner  

Please summarize the partner's specific support and commitment to the project in the space below.

*Please complete a separate form for each partner