Proposed Budget	Proposed Budget Period:
Personnel:
Name                            Title             % Effort        Salary         Fringe            Total
	Total Personnel: $_____________
Supplies:
___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
	Total Supplies: $_____________
Equipment (not usually funded in Pilot Programs)                                             - - - - - - -
Travel (not usually funded in Pilot Programs)                                                    - - - - - - -
Other:
___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
	Total Other: $_____________
	Total Pilot Project Costs: $_____________
EHSC Pilot Project Application	Page 2                                                             Rev. 3/99
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