The form below is intended for New Program Applicants of the Community Wellness Program. The application below must be completed and submitted in full by July 31, 2023.

Please do not complete the below application if your agency is a Returning Partner (unless applying for a completely separate new program). Returning Partners’ applications will be accepted from June 2 to June 30, 2023. Please review the Required Documentation to gather necessary documents and prepare your application.