Forward Health Foundation Grant Application
Organization/Department
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Name on Contact Person
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First Name
Last Name
Phone Number of Contact Person
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Area Code
Phone Number
Amount Requested
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Date
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Month
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Day
Year
Date
Please indicate the fund from which you are requesting support:
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General
Cornerstone Employee Giving Fund
Community Health Needs
Cancer Fund
Briefly explain the project or equipment for which you are requesting funds.
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How will this project address on of the Foundation's focus areas?
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Prevention: Supporting efforts to prevent disease and promote healthy lifestyles
Enhance & Support Local Health Care: Supporting programs, initiatives and equipment that enhance patient care, resident care, and support providers and staff in their work.
Community Health Needs: Collaborating with area organizations who seek to improve health and quality of life residents in the Deer River Area.
What are your intended outcomes for the project?
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All requests need and authorized signature:
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Submit
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