Please describe in detail your proposed policy or environmental change(25 points):

Please list materials that will be purchased and the price of the materials for your proposal(25 points):

I, by signing this application, agree that all monies awarded to me by R.E.A.C.H. and the Robeson County Health Department will be used for their intended purposes. I also agree to attend the mandatory meeting and will agree to provide all necessary documentation to the Robeson County Health Department. Signature: Date:

I, the principal/lead administrator, for ______________________school agree to assist the Robeson County Health Department in ensuring that all funding is used for the project explained above. ____________________________________________________________________ Signature: Date:

INSTRUCTION PAGE

APPLICATION PART 1

EVALUATION QUESTIONS