2022-2023 CDBG Grant Application
Deadline: Friday, April 20, 2022 at 5:00 pm
Organization Name:
*
If using a fiscal sponsor, name of sponsoring organization:
Date of Incorporation:
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State of Incorporation:
*
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
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Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
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Svalbard
eSwatini
Sweden
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Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
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Uruguay
Uzbekistan
Vanuatu
Vatican City
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British Virgin Islands
Isle of Man
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Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail:
*
Alternate E-mail:
Website:
Phone Number:
*
-
Area Code
Phone Number
Alternate/Cell Phone Number:
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Area Code
Phone Number
Executive Director:
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Primary Contact (if different from above):
Organization Type:
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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?
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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.
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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.
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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):
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0/500
Document Upload
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):
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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.
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What have been the major sources of funding sustaining these services during the past 3 years?
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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.
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Please provide an audited financial statement for the past year.
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If required, please submit you most recent IRS Form 990 (for incorporated nonprofit organizations):
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Please provide a list of the officers and/or Board of Directors of the organization:
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Signature
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