Mayor s Matching Grant Application for Schools and Non-Profit Organizations

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1 Mayor s Matching Grant Application for Schools and n-profit Organizations Please complete the following Application Form, answering all questions completely and providing requested supporting documentation and attachments. Incomplete applications, including all required attachments and documentation, will not be considered. Applicant Information School or n-profit organization s legal name DBA Legal Address Mailing Address CEO/President Fax Project Leader Title Website TIN# What year was the school or non-profit organization established? 1. What are the school or non-profit organization s primary services and programs in the community? 2. Describe the source, amount, purpose and date received of your top 5 funders in the past 3 years. Source Amount of Grant Purpose Date Received 3. What other funding sources are being pursued or requested for this project? 4. Is a funding advance required? If yes, how much?

2 Cash Advance Justification: 5. Signature of the Executive Director, CEO or Board Chair who verifies the information contained in the application is accurate and correct and confirms the organization s application for the Mayor s Matching Grant. Executive Director, CEO or Board Chair Executive Director, CEO or Board Chair (Type or Print) (Signature) Date Alternate Project Leader Information Alternate Project Leader Project Description Program Name Amount of City funds requested $ (Grant funds may be requested in increments of $500) Provide a detailed description of the program; the identified need that the program will address; the targeted population to be served; recruitment strategy; frequency and dosage of program/project activities; how grant funds will be used to support the program; program/project timeline; geographic area to be served; organization s history and experience providing these services; volunteer recruitment, training and retention strategy; partnership with other organizations or businesses to provide the program and staffing plan (t to exceed 2 pages) Where will project activities take place? Please provide specific addresses for location(s). All grant funded activities must take place within the Orlando city limits. How many participants do you anticipate will participate in this project? Children/Youth: Adults/Parents:

3 YOUTH AND COMMUNITY IMPACT Provide at least two program performance measures that will be used to evaluate the program/project effectiveness and impact. Include activities, indicators, tools and frequency of data collection. Outcomes define the changes or benefits that result from the program being offered by your organization. Please indicate the process by which impact is measured (i.e. pre & Post testing, assessment tools). You may include outputs to support your outcomes. In assessing a grant application, programs that can quantify their impact are seen more favorably in the assessment process (e.g. 80% of children improved their teamwork skills based on pre-post surveys ). (Do not exceed 1 page.) Youth Crime Prevention Program Performance Measures OBJECTIVE Improve outcomes for at-risk youth in crime prevention programs by establishing and strengthening collaborative community approaches PERFORMANCE MEASURES Number of Program youth served Number of contact hours with youth participants Number of program youth completing program requirements Number of youth who showed an increase in developmental assets DATA THE GRANTEE PROVIDES PER QUARTERLY REPORTING PERIOD Current youth enrollment Number of hours youth are engaged in project related activities Number of program youth who exited the program having completed program requirements Number of youth who exited the program during the reporting period (both successfully and unsuccessfully) Number of youth increasing assets based on pre and post test Number of youth who completed the pre-test at beginning of contact ESTIMATED OUTCOME Program Performance Measures OBJECTIVE Improve academic or educational levels in City of Orlando youth by implementing a comprehensive and engaging learning environment that connects youth with a positive prosocial peer group. PERFORMANCE MEASURES Number of Program youth served Number of contact hours with youth participants Number of program youth completing program requirements Number of youth who showed an increase in educational or academic level(s) DATA THE GRANTEE PROVIDES PER QUARTERLY REPORTING PERIOD Current youth enrollment Number of hours youth are engaged in project related activities Number of program youth who exited the program having completed program requirements Number of youth who exited the program during the reporting period (both successfully and unsuccessfully) Number of youth increasing educational or academic level(s) based on pre and post standardized test(s) Number of youth who completed the pre-standardized test at beginning of contact ESTIMATED OUTCOME

4 BUDGET Complete the Proposed Budget and Match Contribution Worksheet that is linked under the application on the application page. Do families pay a fee to participate? If yes, what is the fee? $ per. (i.e. $25 per child) Will any part of the grant being requested be used to assist families unable to pay? If yes, how much? ($ for participants (i.e. $500 for 50 participants) Partial Funding and Sustainability Grant requests may be approved for full or partial funding, If the organization receives partial funding, can the program still be implemented, and/or can additional dollars be raised? If yes, how? Did a representative from the school or non-profit organization attend an application workshop? If so, what date: Indicate the name and contact information of the individual who completed this application. Name Phone Number Address

5 Application Checklist Instructions: Review the following items to ensure required documents are attached to the application and the application has been thoroughly completed. Incomplete applications will be returned to the applicant. Attached? Is a completed W-9 form for the school or non-profit organization attached? Is application signed by the proper persons to approve application? Are all application questions answered thoroughly and completely? Is documentation of the school or non-profit organization s non-profit status attached? Is a Match Contribution Worksheet Completed, documenting all volunteer, in-kind and cash contributions to the program/project? Are all Letters of Intent forms completed and attached for in-kind and cash contributions? Is a Proposed Budget completed and attached, including a Budget Narrative of expenses? Do all project expenses that exceed $250 per unit cost include at least three estimates from established vendors? Are Letter(s) of Support from community partners attached? Did a representative from the school or non-profit organization attend an Application Workshop?

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