General Information

Application DUE DATE: Friday, July 20, 2018

Please complete this application to the best of your ability. It should take you about 30 minutes to do so and you must complete the application in one session. Be sure to hit submit once you have completed all answers.

This application is built with survey logic so that you get questions that are most appropriate to your city, based on the answers that you provide. Be sure to hit submit once you have completed all answers.

Please provide the following:

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* 1. Please provide the following:

Geographic region (select one):

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* 2. Geographic region (select one):

Number of fulltime employees:

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* 3. Number of fulltime employees:

Number of part-time employees:

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* 4. Number of part-time employees:

Has your city joined the Healthy Eating Active Living Cities Campaign (http://www.healcitiescampaign.org/)

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* 5. Has your city joined the Healthy Eating Active Living Cities Campaign (http://www.healcitiescampaign.org/)

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