IAHPERD
Jump Rope For Heart
Grant Application Form
1. Fill out the information below

2. Print this page (click here or hit your print button)

3. Proceed to the Application Cover Page if you have not done so already


This is page 2 of a 2 part form which must be completed to be considered for a Jump Rope For Heart grant. Please provide the information requested by the form below. All fields must be completed to receive consideration. Please make sure to fill out the application page as well. Click the following link to proceed to the application page. Application Page
The applicant hereby assures IAHPERD that:
  1. The applicant has the necessary legal authority to apply
    for and receive the proposed grant.
  2. The project will be administered in conformity with the
    provisions of title VI of the Civil Rights Act of 1964 and
    provisions of Title IX of the Education Amendments of
    1972, and any regulations thereunder.
  3. No funds received under this grant shall be used to
    supplant funds normally budgeted to provide comparable
    services or programs.
  4. The project is in compliance with the National Research
    Act of 1974 (P.L. 93-348) and appropriate informed consent
    relative to health and privacy of human subject will be
    obtained.
  5. Should the project proposal not be completed, such funds
    as awarded will be returned to the association.
We do hereby certify that all of the facts, figures, and projections made in this
application are true and correct to the best of our knowledge and belief.

Application Information
Applicant Name:
University, school or agency which assumes professional responsibility:
University, school or agency which assumes financial responsibility:

Project Director Name
____________________________
Signature
Date

Department Head Name
____________________________
Signature
Date

Principal/ Dean/ Director Name
____________________________
Signature
Date

Financial Administrator Name
____________________________
Signature
Date