HIP Rapid Response for Census 2020/COVID-19

Address

Phone Number

Area Code Phone Number
Extension
Website
Contact Information:
Full Name

First Name Last Name
Phone Number

Area Code Phone Number
Extension
E-mail
Part II - Organizational Eligibility
All organizations must meet the following requirement:
U.S. state(s) in which activities will occur - eligible states are as follows:

Alabama Arizona Arkansas Florida Georgia Louisiana Mississippi New Mexico North Carolina Oklahoma South Carolina Tennessee Texas
Is the applicant organization incorporated as a nonprofit? *

Yes No
Tax exempt under section 501(c) 3? *

Yes No
If tax exempt, indicate Tax ID #
If not tax exempt, is there a fiscal sponsor?

Yes No
Fiscal sponsor Tax ID #
Part III - Census 2020/COVID-19 Funding Request
1. Provide a brief summary of the needs and strategy to conduct Census 2020 outreach to predominantly Latino populations in eligible states in the U.S. South, while adjusting for complications due to COVID-19. (750 word limit):
2. Project Budget - Provide a very brief project budget between $5,000-$10,000 - funds should be used within 6 months. Administrative overhead funds may not exceed 20%.
Other materials, if necessary
Before submiting, please review your application and make sure you have answered every field correctly and uploaded all the right documents.
Should be Empty:

Part I - Organizational Information