The Fulton-DeKalb Hospital Authority (FDHA) Community Engagement Form for funding is a request for an opportunity offered to health and community seeking one-time support for health events, community-based activities, or healthcare resources that align with the FDHA mission. The FDHA Community Engagement Form serves as a request for funding; however, it is not an application for a grant. The Community Engagement Forms received are reviewed at our headquarters and approved by the CEO and Chairman of the Board.

All funds received from the Fulton-DeKalb Hospital Authority must be spent in the calendar year (January-December). If an event or program is not held in the calendar year, all funds must be returned to the FDHA. Applicants with requests for amounts over the limit will be disqualified.

January 31
April 30
July 31
October 31

Step 1

Gather all supporting documents for upload

• Current 501c3 Letter
• Organization W9
• Itemized Budget (Download Template)

** NOTE: You must specifically name each expense, requested amount from The FDHA and total cost. Salaries/funding (employees, contractors and facilitators are not allowed), no equipment purchases, no overhead expenses (rent, phones, etc.), no indirect costs, no marketing expenses, no transportation expenses, funds for refreshments and incentives should be minimal.

Step 2

Read the following application requirements

Proposed services, Programs, or events:

• MUST Align with The FDHA core area of focus (Access to Care, Breast Cancer, Cervical Cancer, Prostate Cancer, Diabetes, Heart Disease/Stroke, HIV/AIDS, Mental Health & Violence Prevention). 
• Reach youth & Adolescents in the core areas of focus.
• MUST include an itemized budget that adheres to restrictions listed
• MUST serve residents of Fulton & Dekalb County.  

Step 3

• Begin the application by navigating to the next section below and fill out the form, complete each section, and upload supporting documentation. (Google Chrome Browser is Recommend to apply)
• Once you start the application at any time you can save your work by clicking Save and Continue. Note that any document uploads will not save, only the text in the form fields) Once you save and continue a unique link will be generated and you will have the ability to email the link to yourself for future completion. 
• Once complete, submit the application. After submission you will received an email notification to confirm you submission.