Description of Proposed Renewal Activity

Why do you need this renewal opportunity? (Describe what is occurring in your professional life only that causes you to need renewal. Personal needs for renewal will not be considered.)

What is the goal(s) of the experience and what specific activities will you engage in to accomplish this goal?

What is the timeline of your activities?

How will this experience renew you professionally?

If you plan to use grant dollars to pay for someone else’s expenses, explain who they are and why they are integral to your renewal experience.

If this is not applicable, please put N/A.

What follow-up activities might you anticipate for the year following completion of your renewal experience?

Budget Information

You may apply for up to $12,000. Detail all anticipated expenditures. All expenditures must be integral to your renewal process. See Renewal Guidelines for additional information on allowable budget expenditures.

Please do not include commas in dollar figures.

Expense and calculation (if applicable)

Total Cost

Amount from Grant Funds

Amount I Will Pay

Former Questions

I have attached my budget detailing all of the requested information.

If you attach your budget and save and resume, you may not be able to see your budget when you resume your application. We suggest you attach your budget right before submission.

You may apply for up to $10,000. Detail all anticipated expenditures. All expenditures must be integral to your renewal process. See Renewal Guidelines for additional information on allowable budget expenditures.

Please attach an Excel file or Word document that includes the following information for EACH expenditure:

Calculation (if applicable -- not mandatory)
Total cost
Amount of money used from grant dollars
Amount of money you will pay out of pocket
The total cost of all expenditures

What else is going on in your life that causes to need renewal?

Required Agreements

I certify that I intend to remain in human services and at my current organization for at least two years after November 30, 2025. (This is a requirement of the Human Services Professional Renewal Program participants).

I certify that my executive director (or board chair if you are the executive director) has reviewed and approved this application.

I understand that once my application is submitted, I cannot make changes.

I understand that I am responsible for paying any applicable federal, state or local taxes on all grant dollars and that I have the opportunity to include my estimated tax liability in my grant budget (within the limits contained in the guidelines).

Work Email	Personal Email
Work Phone	Cell Phone
Age as of application deadline

Human Services Professional Renewal Grant Application