77 Ill. Adm. Code 950.330
Application
Section 950
Section 950.330Â Application
The Department shall provide a
written application, instructions, and forms to potential or requesting
applicants. In addition to other items required in this Part, the Department
shall request at least the following items in the application:
a)Â Â Â Â Â Â Â Â The name, address, and telephone, facsimile, and
teletypewriter numbers of the applicant.
b)Â Â Â Â Â Â Â Â The name, address, and telephone, facsimile, and
teletypewriter numbers of the entity through which the application is being
submitted.
c)Â Â Â Â Â Â Â Â A two-page non-technical abstract that describes the
significance of the applicant's program concerning prostate or testicular
cancer.
d)Â Â Â Â Â Â Â Â The Social Security Number, Taxpayer Identification Number, or
the Governmental Unit Code assigned by the State Comptroller.
e)Â Â Â Â Â Â Â Â The signature of the agency official authorized to certify the
application.
f)Â Â Â Â Â Â Â Â A detailed budget for the funding period, documenting
sufficient resources to carry out the program. The budget shall be by line
item category and shall provide sufficient detail to justify the use of grant
funds to support program activities.
g)Â Â Â Â Â Â Â Â An approximate timetable for completion of the entire program.
h)Â Â Â Â Â Â Â Â A signed statement of assurances indicating compliance with
applicable State and federal statute and regulations.