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Working with individuals, local, national, and global communities in creating preventive culturally sustainable health and education solutions!

Health International Network System and Institute

Holistic Community Public Health Programs, and Thesis and Dissertation Education Services

HINS Institute for Dissertation Community Mental Health Public Health Education Public Health Programs HINS Client Center for Forms and Brochures HINS Reports, Kudos, Awards, and Students' Presentations

STRATEGIC PROGRAM SERVICE PROPOSAL FORM

Confidential Request for a Grant Development Dialogue


Invest a few minutes with us, and you will discover how experienced our staffs are, and how delightful and affordable our services are. And what's more, our initial services:
ALL FOR FREE!


Please complete this form to begin a free one-hour dialogue for our Strategic Program Services:


Name of Organization:
Address:
E-Mail Address:
Phone Number:
Best time to contact:
Fax Number:
Web Address:
Contact Person:
Title:


TYPE OF ORGANIZATION INFORMATION EDUCATION SERVICES
Faith-based organization
Government agency
Public non-profit organization
Private non-profit organization
Community-based organization
college/university
For profit health
Others



                                
              
   


                                    
   











A printed copy of this form and/or other relevant documents may also be sent by mail or fax to:

Health International Network System
3168 Thirty Fifth Street South, La Crosse, Wisconsin 54601, USA
Phone: +608.787.8997   +608.317.9131   +Fax: 608.787.6660

HINS/AOJ/05/001/2