UMDNJ Community Program Inventory

Community Program Inventory - CPI

Program Name:
Program Manager :
Address:
Telephone:
Fax:
Email:
Website:

*Program Objectives*	[Briefly list the primary goals of this particular program.]
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.	1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Current Year Budget

$

Date Program Founded:

Funding Sources [Check all that apply]	Total Grant $ per Year	Expires
City	$
State	$
Federal	$
Corporate	$
Foundation	$
Private	$
Other, specify:	$

Total Program Funding

$

# people served per fiscal year (approx.):

Target Population(s)	Program Location	Program Description
Infants Adolescents Adults Elderly Ethnic Minorities Other	UMDNJ Facility Hospital Clinic School Faith Based Organization Community Center Other (please specify)	Education Research Public Policy Clinical /Preventive Services Community Service Neighborhood Development Economic Empowerment Other (please specify)

Sponsoring School(s) or Unit(s) [Check all that apply]
Central Administration New Jersey Dental School Robert Wood Johnson Medical School School Of Osteopathic Medicine University Behavioral HealthCare Others	Graduate School Biomedical Sciences New Jersey Medical School School of Health Related Professions School of Public Health University Hospital School of Nursing

Program Staff	Resources Available for Distribution
Faculty Students Staff Volunteers Hospital Staff Non-Hospital Staff Other (please specify)	Publications Curricula Case Studies Outcome Studies Press Releases Other

External Partner Organization(s)
[Non-UMDNJ groups that participate.]