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ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff0000040000002701ffff030000000000}}}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid10884882 
\par 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid16650548 Application for funding from NCCHA for student projects/programs
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par }\pard\plain \ltrpar\s2\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid610254 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 PURPOSE
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
NCCHA will make available to college students/groups/organizations, matching funds of up to $500 for projects/programs that are directly applicab
le to College Health.  It is the expectation of NCCHA that by having a funding source available, students will become actively involved in issues related to College Health, and thereby contribute to the enhancement of the overall health and wellness of co
llege students within the North Central Affiliate. 
\par 
\par }\pard\plain \ltrpar\s2\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid610254 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 ELIGIBILITY
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
The applicant\rquote s institution must be an NCCHA member in good standing, with current membership dues paid in full.  A formal application form must be submitted (see NCCHA website for downloadable forms).
\par 
\par A written request (including financial statement) must be electronically submitted (via attachment) to the NCCHA President (see NCCHA website or recent newsletter for address).  It is the discretion of the Board to consider or reject a proposal 
based on the financial status of NCCHA at the time of request and merits of the proposal.  Only one program/proposal per institution will be funded during any given year.  Project or program must be directly applicable to college student health.  
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9114167 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid610254 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid610254 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 NCCHA Student Grant Guidelines
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10884882\charrsid10884882 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 A.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar\jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid16650548 Statement of Purpose:  What is the intent of the program?
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 Ra}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9114167 tionale (}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9114167\charrsid536296 background information; needs assessment completed; }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid16650548\charrsid536296 why is this initiative important)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par }\pard \ltrpar\ql \li1440\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 Goal (broad statement related to the intended overall outcome or direction)
\par }\pard \ltrpar\ql \li1440\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 Objectives (specific, achievable results; measurable accomplishments)
\par }\pard \ltrpar\ql \li1440\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 4.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 Ta}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9114167 rget Audience (who will benefit}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid536296 )}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cf6\insrsid10884882\charrsid536296 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid536296 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid536296\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 \hich\af0\dbch\af0\loch\f0 5.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 Activities (who, what}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9114167\charrsid536296 
 venue will be used}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 , when, where and how)
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 \hich\af0\dbch\af0\loch\f0 6.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 Expected Outcome (define; provide evaluation}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid16650548 )}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882   
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid536296 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid536296 
\par 
\par 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 B.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar\jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid16650548 Financial Statement
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 A matching monetary commitment, in writing, from applicant\rquote s home institution is required to be considered for funding.
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid610254 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 An itemized estimate of projected costs is essential}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid610254\charrsid536296 . }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7749037\charrsid536296 Food or \lquote food stuff\rquote }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296  should}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid7749037\charrsid536296  be included within the budget request if it is }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 to }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7749037\charrsid536296 
be used to compliment the proposed project/program. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid610254\charrsid536296 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 A written account of applicant\rquote s distribution of NCCHA funds is required, and must be submitted to the Board within (60) days of the completion of the project. 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 C.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar\jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid16650548 Project Awards/Rejections
\par }\pard \ltrpar\ql \li360\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin360\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 If clarification is needed to determine awarding of project, the board Member-at-Large from the state of the applicant\rquote s institution will seek clarification from the applicant.
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 NCCHA will notify applicants, in writing, of the decision to fund or not fund the project within 30 days of the Winter Board meeting.
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 Applicants that have been awarded NCCHA funds can reapply every other year.  Those }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 not receiving funds may apply yearly.
\par }\pard\plain \ltrpar\s17\ql \li720\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid6449888 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid6449888\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6449888\charrsid536296 \hich\af0\dbch\af0\loch\f0 4.\tab}}\pard\plain \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid6449888\charrsid536296 Project/programs awarded }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 are encouraged to}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6449888\charrsid536296  present at the ²ÝÁñÉçÇøOR NCCHA }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid10884882\charrsid536296 annual meetings}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6449888\charrsid536296 . 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 \hich\af0\dbch\af0\loch\f0 D.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar
\jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 Project Timelines}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9911549\charrsid536296 
 (coincide with NCCHA board meetings and newsletters)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 :
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f3\insrsid10884882\charrsid536296 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \ltrpar
\ql \fi-360\li2208\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin2208\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 Fall  - Application due - May 1 
\par }\pard \ltrpar\ql \li2208\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin2208\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296           Project/program to begin - September 1 
\par           Project/program completion - December 15 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f3\insrsid10884882\charrsid536296 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \ltrpar
\ql \fi-360\li2208\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin2208\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 Spr}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14250370 
ing  - Application due - November}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296  1
\par }\pard \ltrpar\ql \li2208\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin2208\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296                Project/program to begin - January 15 
\par                Project/program completion - May 15 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 \hich\af0\dbch\af0\loch\f0 E.\tab}}\pard \ltrpar\ql \fi-360\li720\ri0\widctlpar
\jclisttab\tx720\wrapdefault\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 Project Completion (if project is awarded)
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 
Written report to the NCCHA Board evaluating the program in terms of its goal, objectives, outcome(s), evaluations and final budget.  (Report due to the NCCHA Board and the Newsletter Editor 90 days after project is completed 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid536296 Summary article will be written for the NCCHA Newsletter and submitted to}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882  the Newsletter Editor in a timely manner (preferably in time for publication in the next issue of the Newsletter).
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar\ql \fi-360\li1440\ri0\widctlpar
\jclisttab\tx1440\wrapdefault\aspalpha\aspnum\faauto\ls1\ilvl1\adjustright\rin0\lin1440\itap0\pararsid9911549 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882 A completed copy of the project/program will be submitted to NCCHA for use with affiliat
e members as requested.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 
\af0\afs28 \ltrch\fcs0 \fs28\insrsid16650548 NORTH CENTRAL COLLEGE HEALTH ASSOCIATION
\par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0\afs28 \ltrch\fcs0 
\b\fs28\insrsid16650548 STUDENT GRANT APPLICATION
\par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid16650548 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Name of Institution:_____________________________________________        Date:________________

\par 
\par Address: ______________________________________________________________________________
\par 
\par ______________________________________________________________________________________
\par 
\par Name of student organization requesting grant:________________________________________________
\par 
\par Address:_______________________________________________________________________________
\par 
\par Name of Project:________________________________________________________________________
\par 
\par ______________________________________________________________________________________
\par 
\par Project Coordinator (s):
\par 
\par Name\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Phone\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 \tab }{\rtlch\fcs1 \af0\afs20 
\ltrch\fcs0 \fs20\insrsid536296 \tab \tab Email\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par 
\par ______________________________________________________________________________________
\par 
\par ______________________________________________________________________________________
\par 
\par 
\par Health Services Director:
\par 
\par Name:\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Phone\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 \tab }{\rtlch\fcs1 \af0\afs20 
\ltrch\fcs0 \fs20\insrsid536296 \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Email\tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \tab 
\par _____________________________________________________________________________________
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 On a separate page, please provide the }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid4685135 following:}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080\wrapdefault\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {
\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Name of project
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 2.\tab}Rationale (background information; why is this initiative important)
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 3.\tab}Goal (broad statement related to the intended overall outcome or direction.
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 4.\tab}Objectives (specific, achievable results: measurable accomplishments)
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 5.\tab}Target Audience (who will benefit)
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 6.\tab}Activities (who, what, when, where and how)
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 7.\tab}Expected Outcome (define; provide evaluation)
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \hich\af0\dbch\af0\loch\f0 8.\tab}Projected date of completion.
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Name of Applicant (please print): __________________________________________________________
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 Signature of Applicant: ____________________________________________   Date:_________________
\par \tab \tab \tab \tab }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid16650548 (electronic signature)
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16650548 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10884882 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10884882\charrsid10884882 
\par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 
\af0\afs28 \ltrch\fcs0 \fs28\insrsid16650548 NORTH CENTRAL COLLEGE HEALTH ASSOCATION
\par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0\afs28 \ltrch\fcs0 
\b\fs28\insrsid16650548 STUDENT GRANT
\par FINANCIAL STATEMENT
\par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid9911549 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid16650548 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 We, __________________________________________ agree to provide __________________________
\par                           (College or University)                                                               (indicate dollar amount)
\par 
\par in support of ___________________________________________________________________________
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 __________________________________________________                     _________________________
\par Electronic Signature}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549  of Representative\tab \tab \tab }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 \tab \tab \tab Date
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 __________________________________________________}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid536296 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9911549 Title of Institutional Representative}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 
\af0\afs28 \ltrch\fcs0 \fs28\insrsid9911549 
\par 
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid536296 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid536296\charrsid536296 
\par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 
\af0\afs28 \ltrch\fcs0 \fs28\insrsid16650548\charrsid536296 BUDGET
\par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid16650548\charrsid536296 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9911549\charrsid536296 Project budget items\tab \tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid16650548\charrsid536296    }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9911549\charrsid536296 NCCHA Budget\tab \tab \tab Institution/Matching Budget
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\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx3324\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx6756\clvertalt
\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 
\fs32\insrsid9911549\charrsid536296 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1212150\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx3324\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx6756\clvertalt
\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1212150\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx3324\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx6756\clvertalt
\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid1212150\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx3324\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx6756\clvertalt
\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
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\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
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\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
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\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row \ltrrow}\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 Total\cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \fs32\insrsid9911549\charrsid536296 \trowd \irow6\irowband6\lastrow \ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
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\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3432\clshdrawnil \cellx10188\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 
{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid16650548 
\par \tab 
\par 
\par 
\par 
\par 
\par }{\*\themedata 504b030414000600080000002100e9de0fbfff0000001c020000130000005b436f6e74656e745f54797065735d2e786d6cac91cb4ec3301045f748fc83e52d4a
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