Take Action: Healthy People, Places, and Practices in Communities Project

APPLICANT DESCRIPTION PAGE

FORM B

ORGANIZATION NAME _________________________________________

1. Describe your organization/group and its purpose.

2. Describe your organization’s experience in implementing similar projects.

3. Who in your organization will be implementing the proposed activities for the
project?

4. How was the community involved in planning the proposed project?

5. If you are partnering with other groups, please list and describe them below.