Complete the following application by Monday, Feb. 22, 2010. Keep in mind the grant scoring guidelines (appendix A in the RFP).
The following items must also be submitted to Stacey Conrad by the application deadline.

• Application cover letter (optional);
• Letter of support from applicant hospital or health system CEO or other senior-level executive;
• Letter of support from executive leadership of each collaborating partner (including other collaborating hospitals, if applicable); and
• Letter of support from other community members (at least 1, no more than 3).

Attachments may be e-mailed, faxed or mailed to:

Stacey Conrad
Grants Manager
Foundation for Healthy Communities
155 E Broad St, FL15
Columbus, OH 43215
614.221.7614
614.358.2740 (fsx)
staceyc@ohanet.org

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