CLICK HERE: IMPORTANT DATES AND MORE INFO
Organization Name (required)
Name of Person Writing Grant (required)
If funded, person responsible for management and implementation of grant
Organizational Tax ID Number
Mailing Address (for Checks):
Physical Address (for anything that needs to be shipped, if your mailing address is a PO BOX)
Phone number, Fax Number and Email Address
Person Authorized to Sign Contract
Type of Organization (SELECT ALL THAT APPLY) Community-Based OrganizationHealth Care ProviderFaith-Based OrganizationYouth-Focused OrganizationGovernment OrganizationAdvocacy OrganizationEducational InstitutionTax-Exempt 501(c)(3) organizationAmerican Indian TribeOther
What Public Health Region will this grant serve? Region 1 Jefferson, Orleans, Plaquemines and St. BernardRegion 2 Ascension, East Baton Rouge, East Feliciana, Iberville, Point Coupee, West BatonRouge, and West FelicianaRegion 3 Assumption, Lafourche, St. Charles, St. James, St. John the Baptist, St. Mary, and TerrebonneRegion 4 Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin, and VermillionRegion 5 Allen, Beauregard, Calcasieu, Cameron, and Jefferson DavisRegion 6 Avoyelles, Catahoula, Concordia, Grant, LaSalle, Rapides, Vernon, and WinnRegion 7 Beinville, Bossier, Caddo, Claiborne, DeSoto, Natchitoches, Red River, Sabine, andWebsterRegion 8 Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita,Richland, Tensas, Union, and West CarrollRegion 9 Livingston, St. Helena, St. Tammany, Tangipahoa, and Washington
What Parish(es) will this grant serve?
Does your organization have capacity to host meetings or trainings?
If so, what is the capacity limit?
TFL is searching for grantees that have demonstrated ability and experience in community organizing, community planning, health education and promotion, coalition building, advocacy, policy, training, and/or tobacco prevention and control.
Priority will be given to applicants who engage youth aged 13-18 in current programming, promote youth advocacy participation and engagement, and have the ability to provide transportation to and from required activities.
Describe your organization’s: • Mission and purpose. • Specify the type of organization (school, church, or other). • Staffing and administrative capacity. • Experience in health education and promotion, advocacy, policy, training, and/or tobacco prevention and control. • Experience with youth ages 13-17 and with youth advocacy, participation and engagement, and outcomes in your community. • Experience with community event planning. Please provide examples; include purpose/call to action, outcomes, challenges, etc. • Capacity and plan for providing transportation to approximately 8 youth to and from required activities. • What your organization would like to gain from this project at the end of the grant period.
Applicant Response: (Upload your information below in word or PDF document. Please limit your response to 5 pages double-spaced text.) Allowed file types: Word,Excel,PPT,PDF
Please provide: IRS Letter showing your organizations 501c3 ta exempt status High Schools must provide their IRS 990 report Your organization's proof of liability insurance Allowed file types: Word,Excel,PPT,PDF
Does your organization have a Diversity, Equity and Inclusion or something similar statement? * YesNo
If your organization does have a Diversity, Equity and Inclusion (DEI) statement, please upload it here. Allowed file types: Word,Excel,PPT,PDF
Does your organization have a Safe Place or similar policy? * YesNo
If your organization does have a Safe Space or similar policy, please upload it here. Allowed file types: Word,Excel,PPT,PDF