Grant Application - The Community Pharmacy Foundation
NOTE: This grant application should only be used as a reference. All grant applications should be submitted online at: http://communitypharmacyfoundation.org/mycpf. Only online grant applications will be reviewed for acceptance.
Grant Application Details
1. Amount requested
2. For what time period (months)  
3. Grant program/project title
4. Brief description of the objectives for this program/project (5 - 7 sentences):
5. Will it be on-going and self-sustaining Yes   No   N/A  
6. Were other funding sources provided Yes   No   N/A 
  A. If "YES," what were the other funding sources and the approximate funds provided by each
7. Will your organization provide matching funds Yes   No  
8. Does this program/project involve collaboration with another health profession or health professional organization Yes   No  
9. Have you had your work published in a peer reviewed publication Yes   No  
10. List the top 4 anticipated expenditures as a percentage of total budget (i.e. salaries – X%, marketing – X%, data analysis – X%, postage and supplies – X%). Please note CPF does not cover indirect costs.
11. Other comments regarding the grant application or submission process (2-3 sentences).
12. Do you have the capability to create a 3-5 minute video submission describing your final project/study results? Yes   No     Unsure
13. Will your program/project involve pharmacy student participation? Yes   No     Unsure

Organization Details

Applicant Registration Information
  First Name  
  Last Name  
  Email Address  
  Organization  
  Position/Title  
  Prof. Credentials  

What is your organization's contact information?
  Organization's Mailing Address:  
  City  
  State/Province  
  Zipcode  
  Phone (Main)  
  Web Site http://
  Type of organization: For Profit Entity Non Profit