CCHD Local Grant Application

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General Information

Name of Organization*
Mailing Address*
City, State ZIP Code*
Phone Number*
Amount Requested*

Contact Information

Name of Contact*
Contact phone*
Contact Email Address*

Questions regarding grants

Has this organization received a CCHD Local Grant in the past?*

If Yes, what years and in what amount?
What other means does thie organization have for raising the necessary funds?*

Project Information

Please give a project description of no more than 1000 words addressing the following questions:

  • What is the goal of the project or organization? // What problem is it addressing?
  • What will you be able to do with this grant that you would not be able to do otherwise?
  • How many people do you estimate will be helped by this program?  In what ways?
  • To what extent, if any, do the beneficiaries have policy and decision making opportunities?


In addition, please include a budget of no more than one page in length.

Project Description (1000 characters or less)


Attached a Word Document or PDF containing your project description by using the field below.

Grant Application and Budget PDF*
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