Michigan Osteopathic Association

MOA Core Grant Application

Application Deadline: September 5, 2011

* Required Fields

* Nominee:

* Project/Event Name:

* Project Leader & Participants:

* Target Audience:

* Implementation Dates:

* Contact Person(s):

Contact Person Title:

* Phone:

Fax:

* Email:

* Address:

* City:

* State:

* Zip:

* Project Abstract (100 words):

* Project Summary (1,000 words):

Additional support materials may be faxed to (517) 347-1566 or emailed to amessenger@mi-osteopathic.org.

Michigan Osteopathic Association