Laurel Highlands Conservation Landscape Mini-Grant Program 2018 Application Part 1. APPLICANT INFORMATION Applicant Organization: Address: Phone: Fax: Website: Are you an IRS 501(c)3 non-profit organization? Yes No Are you registered with the Pennsylvania Bureau of Charitable Organizations? Yes No Contact Name: Title: Email: Direct Phone:
Part 2: PROJECT DETAILS: DESCRIPTION, SCOPE OF WORK, TIMELINE, PARTNERS Project Title: Project Location: Project Description: Please provide a short concise description of your project. (limit to 300 characters). Project Scope of Work: Please provide a detailed description of the project, include how the project addresses the goals and objectives of the Laurel Highlands Conservation Landscape. (limit to 7,000 characters).
Project Timeline o Expected start date: o Expected end date: o Comments: Please include any additional notes about the project timeline (optional) Partners: Please list partners who will actively be involved with your project. For example, partners may provide project assistance, funding, or in-kind services. List each partner s name, phone, email and a short description of their role in your project. NAME PHONE EMAIL ROLE Integration: Is your project consistent with any local, county and/or state plans (i.e. greenway and open space plans, comprehensive plans, rivers conservation plans). Please list plan and explain how your project supports and/or implements the recommendations in these plans.
Part 3: GOALS, OUTCOMES AND ACTIVITIES A. Applicant projects should reflect the goals and objectives of the Laurel Highlands Conservation Landscape as listed below. Please indicate which goal(s) your project will address. Trail: Promote and support continued development of the trails network to enhance recreation, livability, economic growth, and healthy lifestyles within the LHCL. Land Conservation: Encourage land conservation through strategic assessment and collaboration with diverse partners in the conservation landscape. Water Conservation: Work to the protect and conserve water resources for potable water, recreation, and ecosystem sustainability. Tourism, Outdoor Recreation: Expand the connections between the built and natural amenities in the landscape. Engage community leaders, business investors, tourism professionals, and residents to capitalize on those connections, to promote, enhance, and conserve local natural, cultural, and outdoor recreational resources while encouraging economic development. Infrastructure:Address infrastructure needs of parks, forests, trails and amenities that support outdoor recreation. Communication: Tell the story of the Landscape to build partnerships and collaboration. Create a story map, develop print and/or on-line communication pieces to promote work within the landscape or to build understanding of the value of outdoor recreation and natural resources to quality of life and the economy.
B. Please list your project goal or goals below. Each goal must be accompanied by measureable outcome(s) and a set of activities that will assist you in achieving that goal. Goal 1: Goal 2: Goal 3: Goal 4:
Part 4: BUDGET A. Proposed Budget: In addition to the information below you must submit a proposed budget for your project as an attachment to this application. B. Local Match Details: List local match commitments for both cash and in-kind below: Source Amount Cash or In-Kind Secured or Pending A. Total DCNR LH mini-grant request amount B. Local Match (minimum 1 to 1 match) Cash Match amount In-Kind Match amount C. Total Match amount (cash + in-kind) A. Total Project Cost (total of lines A and C) IMPORTANT NOTE: All projects and project related costs and funding must conform to the guidelines and outlined in the PA DCNR Community Conservation Partnership Program at http://dcnr.state.pa.us/brc/grants/
Part 5: ATTACHMENTS Please attach: Proposed budget Letters of support and letters of commitment of project assistance (funding and/or in-kind services) If non-profit applicant Current proof of IRS 501(c)3 non-profit status Current proof of registration with the PA Bureau of Charitable Organizations