IMPORTANT NOTE: Prior to completing the online grant application, ensure to review the application package. This package includes important information including guidelines, funding priorities, and ineligibilities for funding.

The following section contains instructions for completing a FULL grant application. The grant application procedure is for those seeking more than $25,000 (not for personal property). The application and all forms must be typewritten or computer-generated. The narrative pages must be single-sided, 8-1/2” x 11” white paper. Text may be single or double-spaced, but no smaller than 12-point standard type (such as Times Roman), with one-inch margins on all sides. Each page must be numbered.

If you are requesting grants of $25,000 or less OR if your request exceeds $25,000 for the purchase of personal property only (e.g., lifesaving equipment, you must fill out the SIMPLIFIED grant application.

Please limit the response to subsection C (Grant Application Summary) to one (1) page. Limit the responses for subsections D (Agency Capability), E (Problem Statement), and F (Program Services and Performance Plan) to a total of five (5) single spaced pages. Please clearly identify all sections with subheadings or by referencing section numbers.

Please direct needed questions to the Grossmont Healthcare District at (619) 825-5050 or info@grossmonthealthcare.org in advance of completing these materials.

2021-2022 Grant Application

  • Grant Application Cover Page

  • Grant Application Summary

  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    Please limit the response to subsection C (Grant Application Summary) to one (1) page.
  • Agency Capability, Problem Statement & Program Services and Performance Plan

    Limit the responses for subsections D (Agency Capability), E (Problem Statement), and F (Program Services and Performance Plan) to a total of five (5) single spaced pages. Please clearly identify all sections with subheadings or by referencing section numbers.
  • Agency Capability (Please Describe Briefly)
    1. Your organization's history and accomplishments.
    2. Your experience in the provision of services to the target population identified in your grant application.
    3. What are the current activities and/or programs operated by your organization? An agency brochure may be attached.
    4. List and describe cooperative and collaborative linkages with other organizations that enhance your ability to provide services.
    5. Is the proposed program a new service that the agency will provide? Is this an established program that will be expanded to GHD residents?
    6. Note any organizations or programs in the community that provide similar services, as well as whether you’ve taken any steps to collaborate with them.
  • Problem Statement / Needs Assessment
    If this grant application is being submitted for funding with a focus on a “Community Health Need” (as described on page four (4)), which will assist in addressing one or more of the identified categories, please specifically discuss how the program is proposed to address such needs.

    Please discuss the need for the proposed service(s) in the GHD. Discuss how the service is health-related and not a duplication of existing services. Include quantitative and qualitative data documenting the unmet health needs.

  • Program Services and Performance Plan
    1. What are the program goals and how do these goals specifically address the identified health need(s)?
    2. What are the measurable objectives related to each goal? List specific outcomes and include timelines.
    3. What kind of data will be measured and how will that data be collected?
    4. How will the effectiveness of the program be assessed? How is quality controlled and monitored? Be specific.
    5. How will the proposed program specifically fulfill the elements of the GHD mission statement? See page two (2) for Mission Statement.
    6. How will participants obtain services? Describe the accessibility of the program site(s).
    7. How will your agency generate referrals to the proposed program? How will services be marketed to participants?
    8. What is the justification for any proposed equipment (if applicable)?
    9. For those proposals that desire to be considered on such a basis, how does the proposal demonstrate a collaboration of like providers of service? (See the Grants Policy for specifics and examples.)
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
  • Budget

  • Project Budget Form to be uploaded can be found here.
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    Required for all applicants.
  • All Budget Sources Form to be uploaded can be found here. (Required only if you are requesting more than $25,000 or have an overall operating budget of $500,000 or more.)
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
  • Submission of Grant Application and Attachments

    Note: Attachments not required of Public Agencies.
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    Not required if current version was submitted to the Grossmont Healthcare District in the last five years
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    Not required if current version was submitted to the Grossmont Healthcare District in the last five years
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    (if needed under California minimum audit requirements)
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    (contact GHD about the potential of including related costs in Grant Request)
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
    Not required if current version was submitted to the Grossmont Healthcare District in the last five years
  • Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
  • Grant Application Checklist

    * Not required if current version was submitted to the Grossmont Healthcare District in the last five years.
  • Grant Application Signatures

  • By selecting the "I Accept" button and including your full name and title, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.
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