Community Development Block Grant (CDBG) Public Service Grant Application
Program Year 2025
Submit
Name of Organization
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Alternate Phone Number
Please enter a valid 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 a Fiscal Sponsor
Year Founded
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Provide a brief summary of your organization's history and mission (max.300 words).
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List the amount of funding your organization is requesting in CommunityDevelopment Block Grant funding from the City of Salisbury.
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Summarize the project or program to be funded. Provide specific details of how the requested CDBG funds will be used by writing a narrative describing the program's budget. Provide a proposed budget including other sources as an attachment.
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How does this project or program address the current challenges faced by your organization or the population your organization serves?
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Please check one:
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This specific program or project has never been funded using CDBG
This specific program or project has been funded previously, but there will be a substantial level of service increase over the last year.
None of the above.
Please explain.
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How did you hear about the program?
Social Media
Email
Newspaper
Word of Mouth
Other
If you answered "Other," please list it here:
Please check all that apply. This program or project assists:
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Abused children
Elderly persons
Battered spouses
Homeless persons
Adults meeting the Bureau of Census' definition of severely disabled persons
Illiterate adults
Persons living with AIDS
Migrant farm workers
None of the above
If you selected none of the above, will this program or project serve clientele of whom at least 51% are low-moderate income? See chart below.
Yes
No
Describe your plan for how to verify and document data related to race, ethnicity, and household income.
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Estimate the number of beneficiaries (participants) that will be impacted by your proposed program. Please be specific to the impact the CDBG funds will make.
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Describe the geographic boundary your program reaches.
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Describe your experience with and ability to programmatically and financially manage federal CDBG funds, which requires tracking beneficiary data, reporting, and record retention.
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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.
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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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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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Submit
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