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For AAA use: <br />Does proposal expand or reach new target population(s)? <br />Is there an outreach plan or activities? <br />Includes description of anticipated expenditures? <br />Appropriately credentialed staff or plan for training? <br />Signed Agreement for revised 10% match? <br />Accepted by: <br />Title: <br />Date: <br />Yes No <br />® ❑ <br />® ❑ <br />® ❑ <br />® ❑ <br />® ❑ <br />014 <br />