nriAHEC Header
National AHEC

Northern
Rhode Island
Area Health
Education Center
1 Cumberland Plaza,
(Blockbuster Building)
2nd Floor
Woonsocket, RI 02895

Tel: 401.356.4077
Fax: 401.356.4269
Contact Us

Individual Grant Application

Salutation: Mr. Ms. Mrs. Dr.
Name:
Email:
Phone: (xxx-xxxx) Fax: (xxx-xxxx)
Address:
Town/city:
State: Zipcode:
School Attending:
Major:
Grant Request: ($) Period Grant Will Cover:
Project Title:
Total Project Budget:
Type of request: Community Program Education Program Professional Development Student Support Other

Narrative of Program or Event

Provide a summary describing the educational program or event you are seeking funding for. The summary should contain a complete description of the event or program targeting areas such as who (whether you are an individual or agency) is applying for the grant, what type of program or event will take places, where the program or event will take place, when the program or event will take place, and how the program or event will take place. Clearly state how receiving this funding will support the Northern RI AHEC's mission and include an overview of costs in your summary. Please copy and paste this into the textbox below. To be considered, applications must be 3 pages or less.

Project Budget

Please be aware that the monies awarded to you from nriAHEC are not to be used toward the cost of meals and/or honorarium(s). Receipts for any and all purchases made with these funds are to be submitted to nriAHEC along with the reports.

Project Expenses
(list below)
RequestIn-Kind
Total Project Expenses



Rhode Island Area Health Education Network
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