H80 Grant Number Form.pdf

This is an application form template from the Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), for H80 grant recipients. The form is designed for applicants who currently hold an H80 grant and need to provide their grant number to complete a subsequent application or renewal submission. The form contains a header section reserved for HRSA use only, with fields for grant number and application tracking number. The primary data collection element is Question 1, which requests the applicant's current H80 grant number in the format of H80 followed by two letters and five digits (example: H80CS12345). The instructions specify that applicants must provide their existing H80 grant number to proceed with the application process. The document serves as an initial intake form for HRSA grant administration purposes.