Public Health Awards

2. What best describes who is applying for funding?

   1. A community-based organization
   2. Other
4. How much funding, up to $3,000 are you applying for?
6. Please tell us about your organization and what activities the money will support.
8. How do the activities you want to fund promote the health of the Alpine County community?
10. Feel free to attach supporting information about your organization or mission.

    This is optional. 

12. First Name
13. Last Name
15. Please provide your email and or phone number so that we can contact you about your request.
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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

* indicates a required field