Grant Funding Application

Thank you for your interest in applying for funding from the Region 1 Behavioral Health Board. Applications are accepted on a rolling basis, but please note that funding availability may fluctuate throughout the year.

Funding Request Guidelines

Previous Grant Recipients

Name

First Name

Last Name

Phone

(###)

###

####

Organization

Organization Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Website

http://

Type of Organization

501(c)(3)

Government

Other

Date of Request

YYYY

Funding Request Amount

Use the space below to list each item you’re requesting funding for, along with the estimated cost and when you plan to purchase or use it.

Please provide a brief overview of your agency’s mission and how your work addresses specific community health needs.

What specific project or initiative are you requesting funding for?

How does this project address a documented community health need or gap in services?

What are the primary goals or intended outcomes of this project?

Please provide a brief timeline for the proposed project.

Have you received Region 1 BHB (or other) funding in the past? If so, please describe outcomes or results.

Are you collaborating with any other agencies, coalitions, or stakeholders on this project? If yes, please describe.

Describe how the Region 1 Behavioral Health Board will be recognized or acknowledged in the project or during the event.

How did you hear about us?

Grant Funding Application

Region One Behavioral Health Board