Reach Mini Grant Application Part 1

R.E.A.C.H. to Eat Smart, Move More… NC Application

The application needs to faxed, emailed or mailed to by 5PM on November 16, 2007 to:

Sarah Gray, Robeson County Health Department

460 Country Club Road, Lumberton NC 28360

Fax: 910-608-2120 ATTN: Sarah Gray

****Please note: We will NOT notify you that we have received your application. However, you may email or call Sarah Gray at 910-671-3094 to confirm that we received your application.

Please enter your application information in the chart below. Please use additional pages if needed.

Your Name:

School:

Grade you teach:

Amount of Funding you are requesting(maximum amount $500.00)

Please describe in detail your proposed R.E.A.C.H. project including a time line for your proposed intervention (50 points):

APPLICATION PART 2

INSTRUCTION PAGE