Communities That Care Application

Organizational Information
Organization Name:
Please list the organization name as it should appear on a contract if awarded.
Organizational Mailing Address (as it should appear on a contract if awarded)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Project Contact Person:
Please include professional title.
Project Contact Person Email
example@example.com
Project Contact Person Phone Number
Please enter a valid phone number.
Contract Signatory
Please include professional title and list as it should appear on a contract if awarded.
Contract Signatory Email
example@example.com
Contract Signatory Phone Number
Please enter a valid phone number.

Assess: Community Need (30 Points)
Tell us about your community and why you think you should be awarded. Please include information on local resources (or the lack thereof), special populations within your community, and any local data and information if possible.
- If applicable, please include the rural nature of your community and identify the high-risk health factors you believe are affecting youth in your area with data from the 2023 South Dakota State Health Assessment.
Please disclose if there is already a functioning prevention coalition in your community.
Community Need:

Community Engagements (10 Points)
List individuals or organizations that are interested in participating in and partnering with this project. Explain whether your organization has worked with them previously or if there are organizations you would like to work with that you currently are not.

Letters of Support (5 points)
Applicants should attach letters of support from 2 partner organizations, and 1 from the fiscal agent if different from the applicant organization. Letters should be written by individuals who are authorized to speak on behalf of the organization.

Type a question