FHIA Micro Grant Application
Church Name
*
Health Minister
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Proposed Event Date
*
Amount Requested
*
Please provide a brief description of the project and include how the funds will be used.
*
Project Budget
*
Submit
Should be Empty: