The PTSSD is only able to accommodate a maximum of three (3) grant requests per monthly meeting.  Requests are scheduled in the order in which they are received by the Secretary of the PTSSD Board. The Board meets on the 3rd Wednesday of every month from 6:00-9:00pm from September – June.
There are no meetings held in July or August.

Click on the title/format of the form you need to download…

Grant Request Form

Grant Request Form (PDF)        Grant Request Form (Word)

Co-Sponsored Grant Request Form

Co-Sponsored Grant Request Form (PDF)         Co-Sponsored Grant Request Form (Word)

All Request Forms with all applicable attachments can be emailed to
 Katrina Mansfield at
 or mailed to:
Penn Treaty SSD
702 N. 3rd Street
PMB 38
Philadelphia, PA 19123

Grant Agreement Form

An Agreement will be provided and signed at the time your organization receives your funds.
 It is available here for your advance review of the terms and conditions.

Grant Agreement Form (PDF)          Co-Sponsored Agreement Form (PDF)

Grant Progress Report Form

All grant recipients are required to complete an interim (6 months) and final report (1 year) after receipt of their grant. Please choose the format you prefer and  download the form from the links below.

Grant Progress Report Form (PDF)    Grant Progress Report Form (Word)


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