CHNA9 Funding Opportunities

Mini-grants and sponsorships

The Community Health Partnership of North Central Mass (CHNA9) accepts applications for mini-grants, sponsorships, and scholarships on a rolling basis. Applicants are limited to requests totaling a cumulative maximum of $2,000 per year. The total funding available annually is approximately $20,000.

For the purposes of this rolling fund, the year follows the fiscal year of the CHNA9, which begins on October 1 and ends on September 30. Funding is made available by CHNA9 through the MA Department of Public Health’s Community Health Initiative. All requests must be aligned with the mission of the CHNA9 and in support of one or more Community Health Improvement Plan (CHIP) priorities. Requests are reviewed promptly by a committee of the Board of Directors.

For questions or guidance, reach out to Rosa Fernandez, Programs Director.

Mini-grant and sponsorship application

Organization Name
Email Address
Address
City
State
Zip Code
Phone Number
First Name
Last Name
Name of project/activity/event
Amount Requested
Anticipated Completion Date
Mission
What is the mission of your organization or project?
Goals/Objectives
What are the goals and objectives of the project or activity for which you are requesting funding?
Intended Outcomes
What will be the results of a successful project?
Partnerships
If you are collaborating on this project, please list the other partners and briefly describe their roles.
Additional Information
Is there anything else you would like us to know about this funding request?
Tax ID#
Applying organization or fiscal sponsor
Fiscal Sponsor (if any)
Name of organization
Address of fiscal sponsor (if any)
IRS letter
Please upload the IRS letter confirming nonprofit status of the applying organization/fiscal sponsor.
Form W-9
Please upload the W-9 for your organization or fiscal sponsor
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, 3) you may still be required to provide a traditional signature at a later date, and 4) you are authorized to submit this funding request on behalf of your organization.
1. I agree.
Electronic Signature

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1. Receive an email copy of this form.
Email address

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