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PR Grant Program Application

The following application is for MDA local components to submit a project for consideration to receive a $5,000 PR Grant to use for promoting oral health in their communities. Please complete all fields and click the submit button when finished in order to be eligible for entry. Components must submit one application per project. Applying for the MDA PR grant program does not guarantee component will receive a grant.

Refer to the complete PR Grant Program Guidelines for more information.


Local Component
PR Grant Program Application



Project Purpose (select all that apply):

Describe how your project will help to positively promote or educate the public about the importance of oral health or seeing an MDA dentist. (100 word limit):


Estimated Impact (how many people will be reached and/or impacted by your project?):

Project Budget Breakdown — how do you plan to use the $5,000? (100 word limit):

Project Evaluation — how will success be defined and measured? (100 word limit):

Please add any additional information that would be pertinent and supportive of your grant application (100 word limit):