2024 Healthy Built Environment Application

1. Applicant Name (name of the organization, non-profit, etc. NOT the name of an individual person.) *This question is required.

2. Which county will the project take place in? *This question is required.

3. Descriptive Project Title (7 words or less) *This question is required.

4. Contact Person Name *This question is required.

5. Contact person email address *This question is required.

6. Re-confirm Email Address *This question is required.

7. Contact person phone number *This question is required.

8. Please upload the completed Competitive Requirements form. *This question is required.

APPLICANT INFORMATION