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9801 Renner Blvd., Suite 100
Lenexa, KS 66219
913.895.2800

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Mother Xavier Ross Application

To have your project considered, completely fill-in all information and essay portions requested below. When finished, click Submit to send your application to Sister Judith Jackson at the Sisters of Charity of Leavenworth System Office. Prior to clicking Submit, you can use Print this Page to print a copy to keep for your records.


* Indicates required information
Official Name of Group: * 
Submitting Proposal: 
First Name: * 
Last Name: * 
Title: * 
Address: * 
City: * 
State: * 
Zip: * 
Phone * 
Project Name * 
Essay Portion 
In this box, enter a description of how the project meets the criteria listed in the downloadable brochure and on the website: * 
In this box, enter a description of the service in action: * 
In this box, enter a description of how the project was developed, current funding sources, if any, and how the project will be funded beyond the grant period (include your budget information): * 
Click Submit to send this form. To print the form, click Print Page at the top of this form. This may take a couple of minutes. Please be patient. 
Authentication * 

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Sisters of Charity of Leavenworth Health System © 2008.
updated 5/3/2010
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