FUNDING APPLICATION The instructions and application form (in Word) can be downloaded from the Nevada State Task Force on Alzheimer’s Disease website (), or through ADSD’s grant opportunities webpage (). If you would like the instructions and application emailed to you, please contact: Jeff Doucet, ADSD, at Complete applications will be accepted on or before 5:00 PM on Monday, May 1, 2017. Please submit the Funding Application Form, which begins on the following page, in Word format using a minimum of 12 point font. Relevant attachments are acceptable but not required. submissions are preferred. Please send your completed application to: Jeff Doucet, ADSD, at Other options include mailing to: Jeff Doucet, MBA, CPM Management Analyst 3 Nevada Department of Health and Human Services Aging and Disability Services Division, Resource Development 1860 E. Sahara Ave |Las NV 89104 T: (702) 486-3367 APPLICATION FORM Section A: Contact Information Applicant/lead agency: Name or description of community or communities within the project: Preferred start date for funding (circle one): May 2017 or January 2018 Contact person: Mailing address: Telephone: Fax number: Email address:
FUNDING APPLICATION The instructions and application form (in Word) can be downloaded from the Nevada State Task Force on Alzheimer’s Disease website (), or through ADSD’s grant opportunities webpage (). If you would like the instructions and application emailed to you, please contact: Jeff Doucet, ADSD, at Complete applications will be accepted on or before 5:00 PM on Monday, May 1, 2017. Please submit the Funding Application Form, which begins on the following page, in Word format using a minimum of 12 point font. Relevant attachments are acceptable but not required. submissions are preferred. Please send your completed application to: Jeff Doucet, ADSD, at Other options include mailing to: Jeff Doucet, MBA, CPM Management Analyst 3 Nevada Department of Health and Human Services Aging and Disability Services Division, Resource Development 1860 E. Sahara Ave |Las NV 89104 T: (702) 486-3367 APPLICATION FORM Section A: Contact Information Applicant/lead agency: Name or description of community or communities within the project: Preferred start date for funding (circle one): May 2017 or January 2018 Contact person: Mailing address: Telephone: Fax number: Email address: