Grant Application

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Group Foundation Grant Application

Project Title

Total Funds Requested

Principal Investigator

Current Position(s) of Principal Investigator

Mailing Address of Principal Investigator

Address Line 1

Address Line 2

City

State

Zip Code

Telephone Number of Principal Investigator

Co-Investigator(s)

Institutional Location of Project

Name of Financial Officer who will administer the funds:

award sources? Officer

Address of Financial Officer who will administer the funds:

Address Line 1

Address Line 2

City

State

Zip Code

Have funds for this project been obtained from other sources?

If yes, please list sources and amounts

I accept the conditions governing the award of a research grant as determined by the Group Foundation for Advancing Mental Health.

Date / Time

Date

Time

Signature of Principal Investigator

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