Accelerator Award Interest in Funding Sign-Up

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Any organization that is interested in applying for a PY4-6 Accelerator Award, please fill out the form below.

All funding information can be found here.

Below is a list of important information to review on the website:

Notice of Funding Opportunity PY 4-6: Accelerator Awards
Funding Opportunities Timeline
Strategic Plan 2.0

All other questions can be sent to the email info@mentalhealth.wincoil.gov

Email *

NOTE:

Lead organization must be established for at least three years prior to applying for funding.

Proposal Name *

Organization Name *

Contact Email *

Organization Entity (check all that apply)
*

Not-for-Profit Corporation 501(c)(3) (Must be registered and in good standing with the State of Illinois)

For-Profit Business (Including properly licensed and insured sole proprietorships and individually-owned LLCs)

Hospital

Healthcare organization

Federally Qualified Health Center

Governmental Entities

Department within Winnebago County Government

Other:

Required

Is WCCMHB currently providing your organization funding? *

Yes

What capital area(s) will your proposal impact? *

Human

Social

Physical

Required

Provide a brief elevator pitch. (100 words or less) *

Does your proposal include any collaborators? *

Yes

If there are collaborators who are they?

What is the estimated total budget for the project? *

What is the estimated amount to be requested from WCCMHB? *

What is the estimated timeline for the project? *

Send me a copy of my responses.

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