2016 CommunityCare Application

CommunityCare 2016 Application
GENERAL INFORMATION:
Organization Name:
Address:
Website:
Contact Name:
Phone:
Email Address:
ORGANIZATION INFORMATION:
Description of organization's mission:
YesNo
What year was your organization founded?
How many employees work at your organization?
Are you currently receiving grants/stipends from other sources?
Where is your organization headquartered?
What is your geographic service area?
PROJECT INFORMATION:
Please describe in detail how your organization will utilize the CommunityCare grant money, if chosen:
List the programs your organization offers pertaining to health/wellness, sports/fitness, activities for the mentally disabled, women's/men's health, geriatric health, etc.:
DEADLINE FOR APPLICATION: September 31st, 2016
Should be Empty:

CommunityCare 2016 Application