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Maternal, Child and Adolescent Health Division

Agreement Funding Applications

Below is information on agreement funding applications (AFA) and forms specific to 2018-19 fiscal year.
Register for AFA Budget Meeting​March 31
​AFA Packages Due​April 20
​Budget Meetings for MCAH / BIH​May 23 - 25
​Budget Meetings for AFLP LHJ​June 5 - 9
Required Package
  • AFA Checklist
  • Agency Information Form
  • Attestation of Compliant with the Sexual Health Education Accountability Act of 2007
  • Community Profile
  • Budget Template (EXCEL)
  • Indirect Cost Rate  (ICR) Certification Form
  • Duty Statements
  • Organization Charts
  • Approval Letters
  • Scope of Work
  • Annual Inventory (WORD)
  • Local Health Officer Approval Letter to Conduct FIMR, if applicable
  • Subcontract Agreement Packages
  • Certification Statement for Use of Certified Public Funds, if applicable
  • Payee Data Record, STD 204, if applicable (PDF) 


(916) 440-7259

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