Application Forms and Resources

Use these forms and resources to help you prepare your application.

If you are applying for a SAMHSA grant, you must download the application forms found on Grants.gov. This website is the source for finding federal grant opportunities, downloading forms, and submitting an application. Additional forms available only on SAMHSA’s website also may be required. Read the Request for Applications (RFA) carefully to determine which forms you must include in your application. Applications that do not include all required forms will be screened out and will not be eligible for review.

Additional Forms for Submission

HHS 690 Form

Every grant applicant must have a completed HHS 690 form (PDF | 291 KB) on file with the Department of Health and Human Services. Your signature acknowledges that you agree to comply with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, and the Age Discrimination Act of 1975.

Charitable Choice Form – SMA 170

You may be required to submit an Assurance of Compliance with SAMHSA Charitable Choice Statutes and Regulations form SMA 170 (PDF | 23 KB). Check the RFA to determine if this form is required for the grant program for which you are applying.

Other Application Materials

Assurances and Certifications

When the Authorized Organization Representative (AOR) signs the Application for Federal Assistance SF-424 form, they certify that the statements contained in the SAMHSA List of Certifications (PDF | 11 KB) are true. Their signature also certifies that they agree to comply with the SAMHSA List of Assurances—Non-Construction Programs (PDF | 16 KB).

Additional Information for Completing Your Grant Application  

Last Updated: 12/19/2013