LADIES LEUKEMIA LEAGUE ENDORSEMENTS FOR GRANT YEAR 2024-2025 Submitted in connection with the Grant Proposal of: Principal Investigator:___________________________________________________________ Address: ________________________________________________________________________________ Telephone Number: _____________________________ Cell Number: _______________________ Email Address: _____________________________________________________________ Name of Organization:__________________________________________________________ Name and Title of Department Head (Type or Print) ___________________________________________________________________________________ Signature: _________________________________________________ Mailing Address:_______________________________________________________________ Phone Number: _____ - _____ - __________  E-Mail Address:__________________________ Name and Title of Authorized Official (Type or Print): __________________________________________________________________________________ Signature: _________________________________________________ Mailing Address:_______________________________________________________________ Phone Number: _____ - _____ - __________  E-Mail Address:__________________________ Name and Title of Financial Officer (Type or Print): __________________________________________________________________________________ Signature:_____________________________________________________ Mailing Address:_______________________________________________________________ Phone Number: _____ - _____ - __________  E-Mail Address:__________________________ BACK Ladies Leukemia League, Inc. P.O. Box 9355 Metairie, LA 70055-9355 I.D.# 72-0997410