Tubac Health Care Foundation

Promoting a healthy lifestyle in the community of Tubac, Arizona

Online Form

Organization Name

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Description and Brief History

Amount Requested from THCF

Have you applied or do you expect to receive funding for this project from any other sources? If so, what are the sources & amounts?

Project Description / Program Narrative

Include the following information: Name of project director What population (who and how many will the project serve What services will be delivered to this population When will the services be delivered (project timeline) What results do you expect to bring about; how will you measure success or failure of the project How will you sustain the program after the funding period expires.

Grant Budget

IMPORTANT! Click on the link at the bottom of this form to enter your budget information

Grant Budget Completed

Yes

Title

Name

First Name

Last Name

Business Phone

(###)

###

####

Cell Phone

(###)

###

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Email Address

Employee Identification Number

GRANT Budget Link