GHFA Immediate Needs Community Grant Application

GHFA Immediate Needs Community Grant Application

Open & Ongoing Application - Effective January 1, 2025
Applicants must be Georgia Academy of Family Physicians members. Grants of up to $1,000 will be awarded to address immediate local needs in Georgia including housing, transportation and/or food and medicine. Grant applications will be immediately reviewed and funding transmitted within 3-5 days.

Questions? Contact Kara Sinkule - ksinkule@gafp.org or call 404-321-7445/ www.georgiahealthyfamilyalliance.org
GAFP Member's Name*

First NameLast Name
Address to transmit funding

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Best Phone Number to Contact You:

Area CodePhone Number
Grant Request Amount (Available- UP to $1,000)*
Briefly describe how you will use the grant if awarded all or a portion of your requested amount.
Please add the name of the grantee and the address where the funding should be sent *(if different from above)
I certify that the the information contained in this application is true and complete. I understand that a material misrepresentation or omission of anyinformation is grounds for denial of a grant. I understand that the granting ofassistance is neither a right nor an entitlement, and that the Georgia Healthy Family Alliance shall have sole discretion in determining whether I qualify for or receive a grant.
Certification by Grant Applicant

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