Consortium Grant Writing Assistance

Thank you for your interest in registering an intent to utilize the Consortium's Grant Writing Assistance Program.

Please complete this request form for each grant application you would like assistance with - one grant per request form. 

Please complete this form at least 3 weeks prior to the deadline of the grant for which you are applying. Grants due inside of 3 weeks are ineligible for grant writing assistance. 

If you are applying for federal funds, this form must be completed at least 6 weeks prior to the deadline.

If you do not have a specific grant in mind, do not complete this form, instead email pm@corxconsortium.org to be put on our communication list about upcoming grants and use this form only when you have a grant you would like assistance with.

Type in "NA" if not
Have you completed this form to receive grant writing assistance before?*
Did you receive the funding you previously applied for?
$
If no, did you receive feedback on why you were not awarded?

Thank you for submitting your interest in grant writing assistance

This information will be used to determine your agency's eligibility.

Contact Information

This is the primary contact for the application. 

Primary Contact Name*

Agency Address*
I certify that my agency does not have a grant writer on staff and lacks funding to pay for grant writing services. *
Name county or counties served by agency (Click all that apply)*
Designation of area served (check all that apply)*
(Check all that apply)
What is your organization's annual budget?*
How many full-time and part-time employees does your organization currently have?*

Grant Information

Please complete as much information as possible about the grant being applied for. 

Note: This is the funder (i.e. CDPHE, OBH etc.)
Note: Please include website URL here.
In your own words, describe how your plans for funds match the grantor's intentions.
Grant application due date
Must be greater than 6 weeks for federal grants and greater than 3 weeks for all others.
Anticipated award date
If unknown, enter a date six weeks after the application due date
$
Note: This is the total amount you will be requesting from the grantor. Please enter numbers without any punctuation such as commas or decimals. Grant amount must be greater than $10,000 to be eligible for grant writing services.
What is the focus of this grant as it relates to substance use?*
Check all that apply
What substance does this grant address specifically? *
Check all that apply

Questions, Concerns, or Preferences (optional)

Additional questions or concerns regarding this request.

You should receive a confirmation email immediately upon submission. If you do not see an email, please check your junk mail folder.

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