Grant Technical Assistance Request

A Member Benefit for RHA of TN Organizational Members

RHA of TN is happy to provide letters of support or other technical assistance to organizations who are members of the association. Individual or nonmembers are welcome to complete the request, however please note support may be limited.

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* 1. Name of organization making request

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* 2. Primary Contact

Name

Title

Organization

Phone

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* 3. Funding Agency (ex. HRSA, USDA, Department of Health, Local Foundation)

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* 4. Title of Funding Opportunity

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* 5. Proposed Location/Service Area

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* 6. Assistance Requested

Letter of Support

Assistance Identifying Parnters

Grant Review

Co-Applicant

Other (please specify)

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* 7. Briefly describe the application focus, service area, and any additional information

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* 8. What specific points would you like RHA of TN to emphasize in the letter/application

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* 9. If you have a template letter, please attach it here

DOC, DOCX file types only.

Choose File

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* 10. Who is letter to be addressed to?

Name

Street Address

City

state

zip

Organization

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* 11. When is the application due date?

Date / Time

Date

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* 12. When do you need the letter/assistance?

Date / Time

Date