AMF 2016 Grant Application

2021-2022 CDBG Grant Application

Deadline: Friday, April 9, 2021 at 5:00 pm
Organization Name: *
If using a fiscal sponsor, name of sponsoring organization:
Date of Incorporation: *
State of Incorporation: *
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail: *
Alternate E-mail:
Website:
Phone Number: *

Area Code Phone Number
Alternate/Cell Phone Number:

Area Code Phone Number
Executive Director: *
Primary Contact (if different from above):
Organization Type: *

501(c)3 Nonprofit Organization Unincorporated, Using Fiscal Sponsor Governmental agency For-profit organization
Year Founded: *
List the amount of funding your organization is requesting from the City of Salisbury? *
Summarize the project or program to be funded. Describe the program/project's objectives and how it is aligned with one or more of the goals outlined in the City of Salisbury's Consolidated Plan for community development. State the number of clientele to be served (percentage of your population that is of low- or moderate- income), the geographical boundaries your program affects, and the types of services to be provided, eligibility criteria. *
The City of Salisbury's Consolidated Plan funds (CDBG) must be used to benefit low- and very low-income persons. Describe the estimated average income and sources of income that are typical of the population you will be assisting and which of the City's goals your project proposal will address. Include information about how your program meets at lease one of the CDBG program's national objectives. *
Provide a brief summary of your organization's history. What services or programs provided by your organization. Describe your experience with and ability to programmatically and financially manage CDBG funds. (max. 500 words): *

0/500
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Upload all applicable documents listed below. Click on the "Browse..." button to select a file from your computer. You can upload any common file format (PDF, .doc, .docx., .xls, .xlsx, etc.)
IRS Determination Letter (for incorporated nonprofit organizations):
Attach a detailed project or program budget that specifically identifies how the City of Salisbury's Consolidated Plan funds will be spent. Identify other sources of funding to be used to implement your project or program in your budget. Provide commitment letters documenting the availability of other funding sources. *
What have been the major sources of funding sustaining these services during the past 3 years? *
Current fiscal year operating budget document showing projected budget and actual expenditures to date, as well as prior year's budget and actual expenses. Use any format or document type.
Please provide an audited financial statement for the past year.
If required, please submit you most recent IRS Form 990 (for incorporated nonprofit organizations):
Please provide a list of the officers and/or Board of Directors of the organization:
Signature *

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2021-2022 CDBG Grant Application

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