Proposal Cover Page Preproposal #:

Hudson River Foundation

2021 Call for Proposals

Title of Proposal:

Purpose/Objectives:

Amount of Support Requested: Period for which support is requested:

From _____________________ through ____________________.(MM/DD/YYYY) (MM/DD/YYYY)

Principal Investigator(s): (Name, Title, Address, Phone, e-mail)

Grant Administrator: Payments to be sent to: Applicant's Tax Status(Name, Title, Address, Phone, e-mail) (Name, Title, Address, Phone, e-mail)

Tax Exempt under 501(c)3

Not a Private Foundation

under Sec. 509(a)

Private FoundationNot Tax-ExemptGovernment

Proposal Approval:

__________ _________________________ __________Institutional Representative Signature Date Principal Investigator Signature Date

12-Month Total $

For HRF Use

Voluntary Diversity Questionnaire

Name:

Alaska Native Native AmericanAsian Native HawaiianBlack or African American Other Pacific IslanderHispanic/Latino WhiteMiddle Eastern/North African Prefer not to answer

Name:

Alaska Native Native AmericanAsian Native Hawaiian

Black or African American Other Pacific IslanderHispanic/Latino WhiteMiddle Eastern/North African Prefer not to answer

Name:

Alaska Native Native AmericanAsian Native HawaiianBlack or African American Other Pacific IslanderHispanic/Latino WhiteMiddle Eastern/North African Prefer not to answer

Name:

Alaska Native Native AmericanAsian Native HawaiianBlack or African American Other Pacific IslanderHispanic/Latino White

Middle Eastern/North African Prefer not to answer

Name:

Alaska Native Native AmericanAsian Native HawaiianBlack or African American Other Pacific Islander

Hispanic/Latino WhiteMiddle Eastern/North African Prefer not to answer

Principal Investigator 5

Which of the following do you identify as? Please check all that apply.

Principal Investigator 3

Which of the following do you identify as? Please check all that apply.

Principal Investigator 4

Which of the following do you identify as? Please check all that apply.

Principal Investigator 1

Principal Investigator 2

Which of the following do you identify as? Please check all that apply.

Which of the following do you identify as? Please check all that apply.

The Foundation seeks in the Hudson River Research Grant program, as in all of its activities, to enhance its

work by supporting participants with the unique and varied backgrounds, circumstances, needs, and

perspectives that reflect the diversity of our community. Our ability to assess our success in achieving this goal

and to adopt measures toward that success will be helped by your voluntarily answering the questions below.