Title of the activity or program:

Intended participants:

Beginning date:

End date:

Estimated cost (Use cost estimate from budget form.):

Budget source or code: 

Contact person(s):

Position/Title:

Telephone: 

Email:

Fax: 

Mailing Address:

Members of the Planning Team:

Name                                                 

Title

Planning Tip 1:  Make the planning process inclusive.