2026 Health First Foundation Community Health Grant Cycle

2026 Community Health Grant Cycle for Northern Arizona

Letter of Intent
Name of Organization*
Organization Phone Number*
Please enter a valid phone number.
Organization Website*
www.example.com
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization's Leader (include name and position title, e.g. President, CEO, Director)*

First NameLast NameTitle
Does the organization have any pending legal issues?

YesNo
Primary Program or Project Contact Person*

First NameLast Name
Primary Program or Project Contact Email
example@example.com
Phone Number of Primary Contact Person*
Please enter a valid phone number.
Are you a 501(c)3 Organization?*

YesNo
If you are not a 501(c)3 Organization, do you have a fiscal sponsor?

YesNo
Organization or Fiscal Sponsor EIN*
Year of Establishment*
Name of Program or Project*
Total Program or Project Costs ($)*
Includes amount requested plus other sources of funding from collaborators, in-kind and volunteer support)
Total Amount Requested from Health First Foundation ($)*
Program or Projects Health Priority Area (select all that apply)*

AccessBehavioral / Mental HealthChronic ConditionsSocial Determinants of Health - EducationSocial Determinants of Health - Social and CommunitySocial Determinants of Health - Health and HealthcareSocial Determinants of Health - Neighborhood and EnvironmentSocial Determinants of Health - Economic Stability
Which Northern Arizona Counties will your Program or Project Serve (select all that apply)*

ApacheCoconinoMohaveNavajoYavapai
Is the Organization in good standing with the IRS?*

YesNo
Does this Program or Project include Collaborators or Partnerships*

YesNo
Has this program or project been funded by Health First Foundation before?*

YesNo
Are you Charity Rated? If so, please identify which rating sites (select all that apply)

Charity NavigatorCharity WatchGiveWellGuidestar/Candid
Does the Organization have an active Non-Discrimination Policy?*

YesNo
The 2026 Health First Foundation Community Health Grant Cycle for Northern Arizona process begins with interested organizations submitting an Letter of Intent (LOI). The Foundation will accept LOIs from February 2, 2026 through February 20, 2026, at 5:00 pm. The LOI should be no longer than two pages, typed, and using a minimum of 12-point font, moderate margins, and on the organizations letterhead. Please keep your letter high level, clear, and concise.

LOI Required Content:
- Organization Name
- Program/Project Title and Primary Focus
- Define the specifics of the program/project, target population, and expected health outcomes.
- Describe how the program/project will help individuals and communities be healthier.
- Describe how the health impact will be sustained after the grant term.
  List your partner organization(s) with their role identified. Outline the characteristics of your partnership.
- Total program/project amount (includes amount requested plus other funding sources from partners, including actual funding, in-kind support, and volunteer support).
- Amount requested from Health First Foundation
- Provide a high level and brief outline of the project budget.
We recommend avoiding industry acronyms that may not be familiar to our reviewers of letters of intent and grant applications. Reviewers prioritize clarity, and using widely recognized terms enhances the likelihood of a higher score for your organization's letter of intent or application.

Also required is the latest organization W9 and 990. Upload each file below where indicated.
Letter of Intent*

Your letter of intent must follow the criteria. If it does not, your LOI may not be considered.
Cancelof
IRS W-9 Form*

Cancelof
Upload the Organizations latest 990 or Financials

Cancelof
Acknowledgment
I confirm that all information I entered in this form is accurate and true.

I understand that the information in this form is not for public use and remains confidential depending on the agreement.

I certify that all purchases, invoices, certifications, financial statement, and other legal documents are thoroughly checked and make sure it is accurate.

I understand that this is a competitive grant funding cycle and funding is not guaranteed.

I understand that the letter of intent will reviewed and thoroughly evaluated based on the criteria of the grantor.

I release this company (grantor) and its employees from any liabilities, claims, and demands that may arise during this application.

By signing this form, you agree to the terms and conditions indicated on this form.
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2026 Community Health Grant Cycle for Northern Arizona

Acknowledgment