1.Organization Name

2.Preferred Phone Number

3.Preferred Email

4.Are you a 501(c)(3)?

Yes

No

*5.Councilwoman Armstrong's office is providing an opportunity for a $10,000 grant to one organization for a project that will improve infant and/or maternal health. Please tell us about your proposed project (suggested word count: 500 or less).(Required.)

6.What work has your organization done previously around child and/or maternal health (suggested word count: 500 or less)?

7.What outcomes do you hope to achieve with your proposed project? What metrics will you use to measure success (suggested word count: 250 or less)?

8.Why is this project important? What goals will it further? How will it impact the community?