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Northeast Wisconsin RTAC Funding Request
NEW RTAC is an organized group of healthcare entities and other concerned individuals who have an interest in organizing and improving trauma care within Northeast Wisconsin. It serves as the unifying foundation to bring together all local, county, regional, state, federal and other agencies for the planning, education, training and prevention efforts needed to assure the exemplary care required for pre, acute and post injury trauma patients. The primary purpose of an RTAC is to design, implement and evaluate a trauma system within a region that is data-based, confidential and sensitive to the needs, resources, and limitations of each regional area.
The Northeast Wisconsin RTAC allocates limited funds to help organizations and services fulfill their goals. Our philosophy is centered on supporting requests that benefit the community as a whole. RTAC funds are not guaranteed and are on an “as available” basis.
Organization for Consideration: Date:
Name of Applicant:
Email: Phone / Ext:
Street address:
Project description:
Amount Requested with Breakdown of Costs (i.e. 100 bike helmets @$4.00 = $400.00):
What is the estimated number of people that will be affected by your request?
How does this request relate to the mission of the NEW RTAC?
Are you willing to provide timely feedback to the NEW RTAC after the funds are received and utilized?
Complete and submit to: Dave Taylor, NEWRTAC Coordinator Email: dtaylor@countyrescue.com
2540 Wood Lane, Green Bay, WI 54313 Cell: (920)373-1083
RTAC Use: Date Received ________ RTAC Board Discussion:
Executive Council Decision: Approved _______Denied _______
