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Human Services Professional Renewal Program

Organization Supplemental Application

Due Friday, May 30, 2025

Please submit all questions by email to Isaac.Mervis@uwci.org.

Organization Information

Organization Name

Executive Director Information

First Name

Last Name

Work Phone

Renewal Grant Applicant

First Name

Last Name

I certify this application is being submitted by the organization's executive director.

Need for Supplemental Grant

Please describe the current job responsibilities of the HSPRP recipient and explain why these responsibilities are critical to your organization.

If awarded the supplemental grant, what type of support staff would your organization hire? Please include a description of their responsibilities and the anticipated number of hours per week.

If your organization does not receive a supplemental grant, how will the HSPRP recipient’s responsibilities be managed or adjusted?

Budget

Total amount of supplemental grant requested

Cannot exceed $5,000

Please detail all anticipated expenditures related to contracting support staff

Upload any relevant budgets, estimates, or invoices associated with these expenses.

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

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