COMMUNITY HEALTH SMALL
GRANT APPLICATION
Narrative ( one page)
Project Description
1) Brief description of your clinical group’s organization.
2) Describe the project for which you are seeking a grant
3) What is the overall goal of your project/ program (for example: improve
nutrition, conduct screening, meet a special need)?
4) Please identify 2 measurable objectives for this project.
5) How many participants will benefit from this project?
6) In your own words, how does/will the project/ funds benefit your community?
Work Plan & Budget
1) How will the project be carried out? List specific steps you will take with a time line.
2) Provide an itemized budget.
After completion of the activity please submit the following for reimbursement:
1. Project Summary
2. Recommendation based on the project outcomes
a. How would you change, improve, or implement the program differently?
3. Results of the evaluation
a. Include the evaluation form
4. Receipts
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