Point of Contact Information
General Information
Letter of Recommendation
For the following questions, if an attachment will be provided, please write "Attached" in the form field.
Project Summary
In 300 words or less, provide an executive summary of the programing and/or projects that are most relevant to this year’s theme of health and wellness. This should show a proven record of achievement and extraordinary contributions towards betterment in the selected area. Please include:
[1] The challenge the initiative is addressing
[2] The innovative solution developed to address the issue
[3] Other relevant data, if applicable (e.g., target demographic, milestones, objectives, partners, results, etc.)
Impact Statement
Please indicate in 750 words or less how the organization or individual is improving health and wellness in the United States, particularly in regard to the following:
[1] Breadth of impact, including geographic presence
[2] Role as change agent
[3] Collaboration among partners
[4] Diversity of beneficiaries and Board/staff/volunteer representation, if applicable
[5] Sustainability of the project.
Uploads
(Max 15MB each)
An email confirmation will be sent!
You will receive confirmation via email that your application has been submitted. If you do not receive this confirmation within 24 hours please reach out to contact@chapmanprize.org