Funding Information Center (FIC) Request Form

OUR SERVICES ARE LIMITED TO TEXAS RESIDENTS ONLY

Thank you for your request for a funding/grant search from the Texas Department of State Health Services Funding Information Center (FIC).
Please note that FIC services are limited to clients in Texas.

Required fields are marked by an asterisk (*)

Name:* 

Email:*   

City:*   State (TX) Zip:*   -   (+4)

County:*   

Phone:*  Ext:  Please include area code with Phone, ex. (###) ###-###

Type of Funding Needed (select one):*

Is this a 501(c)(3) non-profit?:*

Please list topics or subjects that you are requesting funding information from the FIC:*

For what purpose will this funding be used? (Please provide specific information):*

In what city or county will this funding be used? If seeking state-wide funding, please reply 'state-wide':*

Have you received funding previously?:*

If so, who provided funding? Please provide the name of each previous funding entity:*

Would you like to subscribe to the Funding Alert Newsletter?:*