Fiscal 2018 Medicine and Health Enhancement Contribution Program Subsidy Application Form Application date:DD/MM/YYYY 1.Name of organization making application Organization name Name and position of representative Address Organization website URL 2.Contact Secretariat Name and position Address In Japan Name and position Address 3. About Program Program name (12 words or less) Overall plan From To Program period Subsidy period From April / March / 2020 Overall plan $ Total program expenses Subsidy period $ Organization’s articles of incorporation or bylaws Business report of previous fiscal year Financial statements of previous fiscal year such as balance sheet, statement of income and expenses, statement of activities, and statement of changes in net assets Pamphlet(s) Receipt number 4.Program Plan 1) Program outline (Approx. 60
Fiscal 2018 Medicine and Health Enhancement Contribution Program Subsidy Application Form Application date:DD/MM/YYYY 1.Name of organization making application Organization name Name and position of representative Address Organization website URL 2.Contact Secretariat Name and position Address In Japan Name and position Address 3. About Program Program name (12 words or less) Program period Overall plan From To Subsidy period From April / March / 2020 Total program expenses Overall plan $ Subsidy period $ Organization’s articles of incorporation or bylaws Business report of previous fiscal year Financial statements of previous fiscal year such as balance sheet, statement of income and expenses, statement of activities, and statement of changes in net assets Pamphlet(s) Receipt number 4.Program Plan 1) Program outline (Approx. 60
2018_MHECP_application.docx