Form Center

Assessment Criteria

Please provide information for a primary and secondary contact for this project, as well as information about the organization or neighborhood association behind the project. Two contacts are required.
Primary Contact*
Primary Contact Phone*
Primary Contact Email
Primary Contact Address
Zip Code
Secondary Contact*
Secondary Contact Phone*
Secondary Contact Email
Secondary Contact Address
Zip code
Continue |Go Back

Proposed Start Date*
Proposed Start Date
Proposed Completion Date*
Proposed Completion Date
Please provide:
1. 1.) A brief summary of the program or project to be completed;
2. 2.) The nature and makeup of your neighborhood and how many people will directly benefit from the program or project;
3. 3.) Who the program or project will benefit; and
4. What need, issue or goal the program or project will address.
Be sure to describe how the project ties into the Threshold Criteria and Grant Objectives. Include a separate document if necessary.
Alternatively, you can upload a file with the project description.
Please describe how the program or project will be carried out. Include a proposed timeline and information about individuals who will be organizing and accomplishing the work. Reminder: Funds from this Grant need to be used between the time funs are received and the time of reporting on December.
Continue |Go Back

Budget Worksheet*
Attach a Neighborhood Empowerment Grant Budget Worksheet to describe your project budget in detail.
Grant Amount Requested*
Cash Match*
In-Kind Budget*
Total Budget*
Who will be responsible for managing the financial accounts and record-keeping required to receive grant payments?
Name*
Address
Phone*
Email
Have you applied, or do you intend to apply for other city grants for this proposed project or program?*
1. Yes
2. No
Which grant programs?

Leave This Blank: