2019 Partner in Health and Wholeness Collaborative Application

Attention: Changes to the PHW Applications

In order to make the application process more efficient, we have updated our applications. You will no longer be able to save and come back to the application. We highly recommend you save your answers on a separate document as you fill out the application so that you do not lose your responses if the application closes for any reason. We also recommend you print this document to prepare your responses BEFORE entering them on this form. Thank you so much for your cooperation!

Please read all instructions and requirements before proceeding to the application.

If you need assistance completing the form, please don't hesitate to contact your regional coordinator or the PHW Program Associate, Michelle Peedin, at PHWinfo@ncchurches.org.

Please note our current mini-grant cycle will be open between June 3rd through July 31st. Once you are approved for the PHW Collaborative you will be eligible to apply for a mini-grant within the following 12 months. Please complete the PHW Collaborative Renewal at least 2 weeks before submitting a PHW Mini-Grant application in order for us to have time to review.

Partners in Health and Wholeness Collaborative Criteria

Congregations applying for membership in the Partners in Health and Wholeness Collaborative are asked to share information on the following required commitments to health and wholeness:

  1. Maintaining tobacco free buildings on worship grounds
  2. Serving healthy food and drink options at congregational activities, events, and meetings
  3. Asking Faith Leader to complete the Clergy Pledge
  4. Sharing the message of health as a faith issue
  5. Integrating at least one church-based activity based on one of the four cornerstones of the PHW program: tobacco cessation and prevention, healthy eating, increased physical activity, or mental health awareness

If your health ministry does not meet the above criteria, please contact your regional coordinator for assistance.

Contact Information

PHW Health Lead's Contact Information
Faith Leader's Title and Contact Information

Congregation Specifics

Being Healthy, Being Faithful - Tell us about your Health Ministry

Success and Challenges - Past 12 Months

Please describe what healthy HABITS, PROJECTS, or PROGRAMS your health ministry has continued or adopted in the PAST 12 months in each "AREA OF HEALTH" below. Please use as many details and examples as possible. Think of this as your opportunity to showcase what your health ministry has begun, sustained, or expanded on in the past 12 months.

Goals and Plans - Next 12 Months

Partners in Health and Wholeness History

Wrap Up

By submitting this application you are agreeing to the PHW requirements of:

  1. having tobacco-free buildings
  2. serving healthy food and drink options at congregational activities, events, and meetings and
  3. having your faith leader submit a clergy pledge.

12 + 3 =