If you require assistance with this application, please call Genesys Health Foundation at (810) 606-7909.

Section I: Required Information for all Applicants

Name Principal Investigator (PI) / Genesys department:

Email

Phone number


Names of other key staff who are involved:


Organization Approval N/A
Name of Department Supervisor:

Date of Project Approval by Supervisor:


Section II: Project Information

Name of Project:


Total project funding amount to be requested from GHF:

Project timeline:

Date funds are needed:


Section III: Project Description

Brief Project Description (two setences):


Project Rationale (two setences):
Why is this important? How will this benefit the organization?


Project goals


Measurable outcomes:


Population to be served:


Benefits to the Genesys Health System community:


How the proposed project supports the Genesys mission and strategic plan:
Improves the health of the community
Optimizes the patient experience of healthcare
Contains healthcare costs
Optional explanation ...

Section IV: Successful Proposal Support

GHF is responsible for administering all program funds to Genesys Health System (GHS). If a proposal is funded GHF will serve in the fiduciary role to perform project accounting.

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