GPNY-Innovation in Gerontology Award
FINANCIAL MERIT AWARD APPLICATION
GPNY will award two (2) Financial Merit Awards to deserving individuals or organizations who strive to achieve innovation and excellence in providing services to seniors. The amount of each award will be $1000.00. The applicant may, for example, have developed a special program that deserves an incentive or be seeking funds for the development of a new workshop or conference. The applicant may be nominated by self or by someone else. The applicant must reside in New York and serve Long Island. All members attending 5 or more meetings during the calendar year are strongly encouraged to apply.
Name
First Name
Last Name
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Phone Number
*
Please enter a valid phone number.
Business Information
*
Company Name
Title
Business Email
*
example@example.com
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Fun Fact About You:
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0/50
Tell us how you would like to use this financial award.
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0/250
How many older adults/organizations who serve older adults do you hope to impact with this innovation?
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1-10
11-25
26-100
over 100
How would this award directly finance all or part of this innovation?
0/250
What would receiving this GPNY innovation in gerontology award mean to you personally.
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0/250
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