Question Title

* 1. Applicant Information

Question Title

* 2. Name of Pastor / Director

Question Title

* 3. Tax Status

Question Title

* 4. Tax ID / EIN Number

Question Title

* 5. Church / Organization website address

Question Title

* 6. Have you or someone from your church/organization attended a Taking Effective Action, Inc. (TEA) African American Pharmacogenomics and Precision Medicine Learning Event(s) (APPLES Program)?

Question Title

* 7. Briefly state your church/organization's health ministry or health/wellness committee's mission, goal, and/or objective(s). [state reason for applying if no health ministry/committee]

Question Title

* 8. Please tell us the approximate number of members your church or people your organization serves.

Question Title

* 9. Geographic area served

Question Title

* 10. If selected for this micro-grant opportunity, how many people would attend the required webinar/training?

Question Title

* 11. Approximate date your church/organization would host an APPLES event after receiving training/attending webinar

Date / Time

Question Title

* 12. Approximate number of people you intend to reach

Question Title

* 13. How will you publicize your APPLES event?

Question Title

* 14. Briefly explain how you would sustain pharmacogenomics, precision medicine, and cardiovascular health education through your church, organization or as an individual.

0 of 14 answered
 

T