Fillable Town of Vernon Grant Application- Fiscal Year July (Town of Vernon Connecticut)

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Town of Vernon Grant Application- Fiscal Year July (Town of Vernon Connecticut)

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Town of Vernon Grant Application-
Fiscal Year July 1, 2021 - June 30, 2022
ATTACHMENT A
1 | Page
Agency Overview
I. Name of Agency: _______________________________________________
II. Grant Request Amount:_______________________________
III. Name of grant contact person: __________________________________________
Title: __________________________________________
Email: __________________________________________
Phone #: _________________________________________ _
IV. Name of fiscal contact person: __________________________________________
Title: __________________________________________
Email: __________________________________________
Phone #: _________________________________________ _
Program Description
I. What program are you seeking funds for?
Town of Vernon Grant Application-
Fiscal Year July 1, 2021 - June 30, 2022
ATTACHMENT A
2 | Page
II. What services will be provided to Vernon residents?
III. What identified need does your program address for Vernon residents?
IV. How do Vernon residents access services? Please describe if there is a limit to how often
residents can access your services.
V. How will the Town of Vernon funds be used to the benefit of Vernon residents?
Town of Vernon Grant Application-
Fiscal Year July 1, 2021 - June 30, 2022
ATTACHMENT A
3 | Page
VI. Please provide the projected unduplicated number of Vernon residents to be served during
FY ‘20/21:
Families
Single Adults
Youth/Children
FY’ 21/22
VII. Please provide the actual unduplicated number of Vernon residents served in the past three
(3) fiscal years:
Families
Single Adults
Youth/Children
FY’ 17/18
FY’ 18/19
FY’ 19/20
VIII. Do you anticipate an increase in utilization of your services by Vernon residents? Please
explain.
IX. How has the Covid-19 Pandemic affected your agency and its operations?
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Town of Vernon Grant Application- Fiscal Year July (Town of Vernon Connecticut)

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Completed 24 January 2021

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