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 it online, or print and send (email/fax) in your application. Forms are for both individuals and           Tribal-Serving organizations. 

Program details listed in the application.  

Additional Information:




(505) 837 - 2104


(505) 837 - 0575

Deadline to Apply: September 30,2020

Outreach Flyers


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If applying via the online form below, you are encouraged to read the details of awardee expectations in the Individual and Tribal-Serving Organization documents above prior to submitting.