HEALTHIER TOGETHER 2021 FALL CYCLE REQUEST FOR PROPOSALS: PROPOSAL APPLICATION FORM

NC Counts Coalition invites organizations that are committed to ensuring equitable COVID-19 vaccine distribution to apply for grants in the range of $10,000-$25,000 for individual organizations. Collaborative proposals among organizations for larger amounts will be considered up to $60,000. Funds will support plans to support NC communities that experience health inequities and to ensure that individuals from specific historically marginalized populations are able to access COVID-19 vaccines in their areas. In the fall of 2021, up to $500,000 will be disbursed for short-term vaccine equity efforts for approximately 4 months (estimated November 2021 through February 28, 2022).
 
If you have questions about this application, please contact RFPQuestions@NCCounts.org. Please include your organization's name in the subject of your email.
 
For a copy of the RFP and resources to help you pull your application together, visit:
https://nccounts.org/funding-opportunities.

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Organization Information

Counties where you will focus your efforts. Please check all that apply and if you are not working in a specific region, select "N/A":
Region 1: *
Region 2: *
Region 3: *
Region 5: *
Region 4: *
Region 6: *
Historically marginalized populations (HMPs) that you will prioritize for outreach. Please check all that apply:
Historically marginalized populations: *
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Narrative Questions

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Program Budget: Please provide a program budget which includes your organization’s current income to support vaccine equity work, the amount of funds your organization will need to execute your plan, and how you will allocate those funds. A suggested budget template is included here. If this is a collaborative proposal, please indicate how funding will be shared with partner organizations. A suggested collaborative budget template is included here.
Attachments- Please include these attachments for your organization or fiscal sponsor.