HIIM Program Grants Application

HIIM Program Grants Application
For more information about eligibility and full requirement details, visit http://www.californiahia.org/hiim-program-grants

Program Directors are required to submit the following information by the annual March 1 deadline.
Program Director Name*

First NameLast Name
Credentials
AHIMA/CHIA ID Number
Name of CAHIIM-accredited College/University*
Name of HIM/HIT Program*
School Address (for disbursement of monies)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
Narrative Response
Provide a clear, concise description of the CAHIIM-accredited program, the number of students in the program, a description of any special needs that the program has and/or how the grant will be utilized to improve the teaching and/or learning in the program (no more than 750 words)*
Supplemental Documentation (optional) (PDF only)

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Narrative Response