Applicant Defined Grant Pre-Application Survey

Applicant Information

The purpose of this survey is to streamline the process for requesting pre-application consultations with Health Forward staff. We recommended applicants—particularly first-time applicants—complete this survey in order to schedule a consultation with Health Forward staff. The information you provide will help us connect you to the appropriate Health Forward associate and help us determine if your potential request aligns with Health Forward’s mission and applicant defined grant guidelines. Following the completion of the survey, someone from Health Forward will reach out to provide feedback regarding your project idea.

1. Your name: *This question is required.

2. Email: *This question is required. This question requires a valid email address.

3. Phone number: *This question is required.

4. Organization: *This question is required.

5. Website (if you have one):

Please review Health Forward’s basic eligibility requirements here.

If no, please explain: *This question is required.

If you are not sure, please explain: *This question is required.

7. What is your organization's annual operating budget? (Optional) This question requires a valid number format.

If yes, please list their name here: *This question is required.

9. Please provide a brief description (a few sentences) of the applicant defined grant you would like to propose. *This question is required.

10. Anything else you would like to share at this time: