GoGrant Sample Online Application
Please note that this is a sample for viewing purposes only!
Applicant Contact
Name
*
First Name
Last Name
Of the following modes of transportation, approximately what percentage would you say your employees/customers/residents etc., commute or travel to your organization’s location currently?
Please Select
Title
Organization
*
Business Website
Email
*
example@example.com
Work Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Number
*
Please enter a valid phone number.
I am the owner/operator of this business/organization, or can speak on behalf of the owner:
*
Yes
No
If not, explain if necessary:
This business/organization is already a Movability member.
*
Yes
No
Is this application for a school? If yes, please provide school name, principal's name and email. If no, proceed to next section.
GoGrant Program Requirements
Please provide name and email address of person who has signature authority for a GoGrant Agreement, if different from applicant.
My Business/Organization is currently located in the Austin city limits.
*
Yes
No
My Business/Organization has: (select one)
*
1-49 employees
50 + employees
My Business/Organization generated: (select one)
*
Under $10 million in revenue in 2022 or your last fiscal year
Above $10 million in revenue in 2022 or your last fiscal year
My Business/Organization, if awarded, is willing to become a Movability member.
*
Yes
No
Project Contact
The project contact will act as the point of contact throughout the duration of the project.
Name
*
First Name
Last Name
Title
Mobile Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Project Proposal
Describe your project and how funds will be used
Project location/address:
*
* EACH GOGRANT APPLICATION SHOULD ONLY BE FOR ONE GRANT TYPE. PLEASE SUBMIT A SEPARATE APPLICATION IF YOU'RE APPLYING FOR MORE THAN ONE GRANT TYPE. The type of mobility assistance funding my organization is applying for:
*
Infrastructure project -- Examples are projects where funding is spent on purchasing materials/goods that make active and micro-mobility more convenient for employees or customers. For this grant type, outcomes need to be a useful and permanent structure, fixture or improvement (eg. bikes, bike racks or lockers, repair stations, designated parking for micro-mobility, covered parking, shade structures, etc.)
Programmatic project -- Examples are the use of incentives and policy to encourage use of active and non-drive-alone transportation modes (eg. discount/subsidies for mobility options, transit pass purchases for employees, micro-mobility purchase programs, subsidized vanpools, gamification, education or marketing programs to bring awareness to mobility programs).
Custom mobility consulting project -- funding is for focused professional services from Movability, including mobility strategic planning, communications and goal setting (e.g. survey and analyze employees and their commute challenges, compile available transportation resources available to employers, "heat mapping," proposed commute strategies).
Describe your project including descriptions of current need, how the project will meet those needs, and project goals/objectives. Details provided will be evaluated and scored by GoGrant's scoring committee to determine which projects will be awarded.
*
Is your business/organization any of the following: (select all that apply)
*
Women-Owned
BIPOC -Owned
LGBT+ - Owned
Serving a historically under represented group (please explain below)
None of the above
If you indicated your organization serves a historically under represented group(s) please provide additional detail.
Project Milestone
Describe your plan for project implementation by listing key milestones and target dates below. (at a minimum include an estimated start and complete date)
Action
*
Target date
*
Action
*
Target date
*
Action
Target date
Action
Target date
Action
Target date
How will you measure the impact of this project?
*
Please describe what baseline and benchmark criteria you will use to measure the impact of the active mobility infrastructure or programming you put in place with this grant funding.
Funding Sources
Total Grant request. Important: If applying for a programmatic or infrastructure grant, please build into your total project estimate $220 to cover Movability staff administrative support time:
*
Project Budget: include a proposed/estimated cost of each item for which the grant funds will be used.
*
Other sources:
Will there be additional funding for the project? If so, from where is that funding coming?
How did you hear about the GoGrant Program? (select all that apply)
Search Engine (Google, Yahoo, etc.)
Email Newsletters
News
Radio
Social Media
Personal Referral
Other
Submit
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