SAIL Program Engagement Agreement Logo
  • Program Engagement Agreement

    Stay Active & Independent for Life [SAIL] Program
  • Part 1 of the two-part Program Engagement process.

    The purpose of this Program Engagement Agreement is to provide clear expectations for the host organization (named here) in implementing the evidence-based SAIL program within the host organization's community - as part of the grant awarded to the Northern Virginia Falls Prevention Alliance. 

    This form is to be completed by the Primary Point of Contact of the Host Organization.

  • HOST ORGANIZATION


  • PROGRAM IMPLEMENTATION SITE


  • PROGRAM SCHEDULING

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  • PROGRAM LEADERS

    Those who will be leading the SAIL program
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  • Part 2 of the SAIL Engagement process consists of:

    (A) Supplies/equipment provided by the grant for the SAIL program at this site.

    (B) Expected implementation process dates and timelines.

    After submitting this form, we will get in touch with you for next steps.

     

    Thank you for completing this SAIL Program Engagement Agreement!

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