Simplified Grant Application

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.

GRANT APPLICATION PACKAGE

The following section contains instructions for completing a SIMPLIFIED grant application. A simplified grant application procedure is available to those applicants seeking grants of $25,000 or less.

If you are requesting more than $25,000, you must fill out the FULL grant application.

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

2022-2023 Simplified Grant Application

Simplified Grant Application Cover Page
Legal Name of Organization(Required)
Name of Agency Director(Required)
First Last
Address(Required)
Street Address Address Line 2 City State ZIP Code
Phone (& Extension) of Agency Director(Required)
Email of Agency Director(Required)
Proposed Project Title(Required)
Name of Agency Contact Person(Required)
First Last
Phone (& Extension) of Contact Person(Required)
Email of Contact Person(Required)
Amount of Funds Requested(Required)
Number of Unduplicated GHD Residents to be Served(Required)
Ages of Population to be Served(Required)
Using the description of a Community Health Need, this program will assist in addressing the following (check only if applicable)
- Aging Concerns
- Behavioral, including Mental Health and Substance Abuse
- Cancer
- Chronic Conditions: Cardiovascular Disease
- Chronic Conditions: Diabetes (type 2)
- Chronic Conditions: Obesity
Brief Program Description(Required)
Budget
Project Budget Form(Required)
Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
See link below for digital form.
Project Budget Form to be uploaded can be found here.
All Budget Sources Form
Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
See link below for digital form.
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.)
Sponsorships
All Sponsorship Sources
Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, Max. file size: 50 MB.
Simplified Grant Application Signatures
Signature(Required)
- I (we) certify that all information included in this application is complete and accurate.
Digital Signature
First Last Title
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.

2022-2023 Simplified Grant Application

Simplified Grant Application Cover Page

Budget

Sponsorships

Simplified Grant Application Signatures