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Form
State of Washington
0"011;
A19 -1A
• -Voucher
AuthorityHealth Care
621 8th Avenue SE
Olympia,
WA 98504
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Grant
County
1 E Plum St
Moses
-
fit RUN • •
TAX IDENTIFICATION NUMBER
MONTHIYEAROF
1 BY DATE RECEIVED
•
June 2021Supplemental
®PROGRAM
•Informafion
I
•
/ • • • . • . • .
Community -Based Coordination-Px
Community -Based Process
Community Coalition Coordinator
Community -Based Process
��Comrrurdty Coalition
Community -Based Process
Community Coalition Coordinator- ML
Community -Based Process
'Community Coalition - ML
Community -Based Process
Dissemination
Positive Action - ML
Youth Empowerment - ML
02
Outreach & Education- M L
Information Dissemination
Talk. They Hear You- ML
Information Dissemination
Under The Influence Of You- ML
Information Dissemination
Character Strong - ML
Information Dissemination
®Information
Dissemination
• -
---------
1 11
® RestorativeEnvironmental
F.
---------
1 11
Coaliftion/Community Training - VL- &(Program Start-up Cost 2500)
FORM
',Community Coalition Coordinator- Q
Community -Based Process
Community Coalition - Q
Community -Based Process
Strengthening Families Program - Q Program Start-up Cost
SPORT PPW- Q- Program Start-up Costs
m9m W, ��_
Healthy Alternatives - Q
Alternatives
'Youth Development- C -
Information Dissemination
MIFF �01
Information Dissemination
Under The Influence Of You- Q
Information Dissemination
Rx Safe Disposal - Q -
Information Dissemination
Starts With One- Q
Information D issernination
Drug Free Parks - Q
Environmental
QHS Disciplinary - Q
Environmental
Coalition/Comm unity Training - Q -
Community Education Workshops - Q-
rpm , W—m
PREPARED DATE
TELEPHONE
- 9/0712021
51 764-2660
A19 Effective 7/1/19 through 6130/21 REVISED 10/2020
CURR 1 • •
/ • tVENDOR
•APPROVAL:
' • Sarah Mariani, 360-725-9401, Sarah.Marianirhw• •
ACCOUNTING• FOR DATE
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71
2009-11 Biennium Contract pageL T r f�-' -,'P
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