Community health leadership program application

Thank you for your interest in the Community Health Leadership Program!

Included below is our Community Health Leader application. You have the option to complete the application online, mail it, or send it by email. Forms are for both individuals and Tribal-Serving organizations. 

Program details listed in the application.  

Additional Information:

EMAIL:

JConcho@keresnm.com

 

Phone:

(505) 837 - 2104

Deadline to Apply: October 31, 2021

Outreach Flyers

CHLP-Flyer-01.jpg
CHLP_Contact Flyer-01.jpg
CHLP_ Flyer2-01.jpg

Application

2020_08.16-CHLP_Application.jpg

If applying via the online form below, you are encouraged to read the details of awardee expectations in the application document above prior to submitting.