General Information


Application DUE DATE: Friday, August 5, 2016

Please complete this application to the best of your ability. It should take you about 25-30 minutes to do so. You have the freedom to leave and come back to where you left off on the survey as needed.

In the email you received about the grant, we included a word document version of the application for reference and so that you can be prepared to answer all questions. The 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.

* 1. Name of city:

* 2. Geographic region (select one):

* 3. Number of fulltime employees:

* 4. Number of part-time employees:

* 5. Has your city joined the Healthy Eating Active Living Cities Campaign (