Texas Chapter Mini Wellness Grant

What are you doing for Physician/Staff Well-being in your practice?

We want to encourage your efforts toward enhancing well-being in your practice with the opportunity to apply for a mini chapter grant.

The chapter will give a $600 to 5 awardees who are interested in building teamwork, wellness, camaraderie or anything that contributes to wellness and work satisfaction.

Applications are due January 15, 2020
The required information to be considered are:

Applicant's Name and Contact Information
Applicant's ACP Number
Proposed Activity for Funding Request
Activity Information (In 500 words or less include: objectives, target audience, number of attendees, dates, anticipated impact)
Budget
Upon completion of activity, grantee will submit a brief final summary of the outcome of the activity by October 1, 2020

Applications will be reviewed by the Chapter's Wellness Committee and award notifications will be sent between January 30 - February 15.

Questions? Please call the Chapter Office at 512-370-1508 or TXACP@texmed.org

Applicant Contact Information

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* 1. Contact Information

Name

Email Address

Phone Number

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* 2. ACP Number:

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* 3. Title/Proposed Activity:

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* 4. Activity Information:

Activity Date(s):

Target participants:

Expected number of attendees:

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* 5. Activity Objective(s):

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* 6. Activity Objective (cont'd)

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* 7. Anticipated Impact:

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* 8. Activity Budget (please enter description and estimated costs per applicable line item):

Expenses:

Promotion:

Materials:

Other:

Total Estimated Cost: