Health Awareness Promotion (HAP) Awards Entry Form
American Medical Association Alliance, Inc.
Entries will be judged only on the written project summary. The summary should contain the following: description of goals, impact on community or target audience, impact on the Alliance, and budget and donation summary.
Tip: This screen may not allow you to print your entire application. In order to have a copy of the application may we suggest typing it out as a Word document first and then cutting and pasting the information into the appropriate sections of the online form.
Project Information: All fields must be filled out to submit form.
Name of Project
New project
Project on-going from previous year
If ongoing, please list Project Bank #
HAP Award Category (Check only one category)
Community Service/Health Education
Fund-raising
SAVE
Alliance Information:
Number of county or RPS/MSS Alliance members
Number of state Alliance members
Number of national Alliance members in your county
Number of Alliance members who actively participated on project
Alliance volunteer hours on project
Official County Alliance name
County President name
President's phone number
Contact name
Contact Alliance position
Address
City
State
Zip code
Phone
Fax
E-mail address
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Project Description: All fields must be filled out to submit form.
Judges will refer only to your project description when reviewing your entry. Please do not refer to the name of your Alliance in the project description.
Project Summary
Provide an overview of your project, your target audience, highlights of the project, your budget, funds, donations and whether or not any co-sponsors were involved. Limit 350 words.
Description of Goals
Briefly outline the project’s goals, what planning was involved, and who was responsible for the implementation of the goals. Limit 350 words.
Impact of Project on Community or Target Audience
Describe and evaluate ways in which your project met its goals and highlight all areas of success. Limit 350 words.
