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Attachment 1 <br />INSTRUCTIONS FOR WELLNESS GRANT <br />PROGRAM SUBMISSIONS <br />GRANT APPLICATION <br />Complete the attached grant application in addition to the program description, <br />projected budget and timelines for the proposed wellness program. <br />PROGRAM DESCRIPTION <br />1. Provide a description of the wellness program being proposed for consideration <br />for the grant. <br />2. Provide a projected program budget for upcoming year. <br />3. Provide a program timeline. <br />PROJECTED PROGRAM BUDGET FOR THE YEAR <br />Present the budget by type of expenditures. Be specific: <br />Expenditure Cost <br />(List using the following categories :) <br />Health risk assessment screening <br />Hypertension screening <br />Smoking Cessation program <br />Additional Program Options (insert) <br />Communication Activities (insert) <br />Other Activities (insert) <br />TIMELINE FOR PROGRAM <br />Complete a timeline for your program and attach it to this application. <br />NCACC Risk Management: 215 N. Dawson St., Raleigh, NC 27603 I Phone: 919-719-1100 I Fax: 919-719-1101 2 <br />