Fill - Free fillable EMERGENCY COVID ASSISTANCE GRANT APPLICATION (CITY OF FOREST GROVE) PDF form

A. Project Title

________________________________________

Amount Requested:

$_______________

B. M

ark all of the goals below which your project meets and explain how:



oals

ow project meets this

goa

(be clear & specific)

Improve the appearance or

environmental quality of the

community

Reduce the amount or toxicity of

waste

Increase reuse and recycling

opportunities

Result in rehabilitation or upgrade of

real or personal property owned or

operated by a nonprofit organization

having 501(c)(3) status under the

Internal Revenue Service code

Result in the preservation or

enhancement of wildlife, riparian

zones, wetlands, forest lands and

marine areas, and/or improve the

public awareness and the

opportunities to enjoy them.

Result in improvement to, or an

increase in, recreational areas and

programs

Result in improvement in safety

Benefit youth, seniors, low income

persons and/or underserved

populations.

EMERGENCY COVID ASSISTANCE GRANT APPLICATION

PROJECT INFORMATION

Signature:_____________________________________

City:__________________________ State:_________ Zip:______________

Address:_______________________________________ Email Address: __________________

Contact Person:________________________________ Daytime Phone:_______________

(N/A for City Board or Commission)

Sponsor:_______________________________________ Tax ID # ___________________

Designed for non-profits who can provide immediate assistance to a vulnerable population in Forest Grove.

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





click to sign

signature

click to edit

Brief

Project Description

and Explanation of how the COVID funds will be used:

Who will benefit if this project is funded?

_____________

Estimate how many Forest Grove

residents will benefit if this project is funded.











































Personnel Services

Supplies

Capital

Materials

Other (please explain):

Total

COVID Sponsor

Other #1

Other #2

PROJECT

BUDGET

% of Total Budget provided by Sponsor: ______

Total Estimated Costs: ___________

Breakdown

estimated

costs

source:

________________________________________

How

were

these

costs

estimated

(quotes,

catalog,

projects,

etc.)?





















PROJECT MANAGEMENT

A. Provide a brief narrative outlining the major tasks and projected time schedule

for completing of each task.

B. Describe prior experience managing similar projects. Include prior Community

Enhancement Projects.

C. Does this project require coordination with other public and private

organizations? Has the necessary coordination been completed? If yes,

please describe.

D. If the project is located on private land, discuss the public benefit of the project

and provide landowner permission for the project with this application.

Street.

Please

limit question responses to the spaces provided.

Applications must be submitted by 5:00 pm,

April

, 2020, at Forest Grove City Hall, 1924 Council



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

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