Request for Special Funding Application

Thank you for your interest in the Harold and Edna Bragg Healthcare Education Scholarship Fund, which is administered by the Lake Chelan Health & Wellness Foundation.

Special Funding is a request for funding not available anywhere else but will help to bring an item or program to a group or individual. We have been privileged in the past to help with funding for the Audiometer for Manson School District, Gift Certificates for kids in the EMS program – “I Caught You” which catches kids wearing their bike helmets while out riding their bikes, Senior Center Yoga classes and our Community Nurse program

Request for Special Funding Application

Name of Organization:*
Date*
MM slash DD slash YYYY
Applicant Name/Title*
First Last
If awarded funds, when will these funds be disbursed for implementation of program/service?*
MM slash DD slash YYYY
Phone*
Email*
Mailing Address:*
Street Address City State / Province / Region ZIP / Postal Code Country
Is your organization governed by a board that receives taxpayer support? (Hospital District, City Council, etc.)*
- Yes
- No
Yes, we are governed by:*
Description of Program/Item for which funding is requested:*
Total Amount Requested:*
Description of how this funding promotes health in our district. Include one measurable objective and expected outcome:*
Are you available for a personal interview?**
- Yes
- No

CONTACT

(509) 682-6125
P.O. Box 1911
Chelan, WA 98816

foundation@LCHealthWellness.com

DONATE

Our Mission

To promote healthcare services and wellness initiatives for the Lake Chelan Valley.

Request for Special Funding Application