Draft FY25 EmPower Massachusetts Innovation & Capacity Building Application Form

First Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Second Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Third Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Fourth Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Fifth Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Sixth Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Seventh Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Eighth Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Ninth Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

10+ Partners
If you have more than 9 partners. please include additional partners' information below.

Grant Funding Proposal (i.e. Proposed Approach)

Please answer the following questions. Brief responses are encouraged.
Provide a Project/Concept Title:*
Provide a 2-3 sentence overview of your proposed project or concept. Think of this as your "elevator pitch".*

0/100
Based on the above, what will the requested funding specifically be used for? For example, "we will use our funding to hire part-time staff to conduct outreach in a Priority Group neighborhood".*

0/200
What is the Priority Group you are seeking to benefit and how will they benefit? Please include whether your proposal would target a geographic community (i.e. City/Town, neighborhood) or non-geographically based community (i.e. affinity group, religious network, shared language community).*

0/200
Tell us about your plans for conducting stakeholder engagement as part of this proposal. Stakeholder engagement is strongly recommended.*

Yes, we are conducting/have conducted stakeholder engagement (please describe below).No, we are not conducting stakeholder engagement (please clarify reasoning below).
Please elaborate on your answer to the above question.*

0/200
What kind of program or project implementation is expected to result from the completion of the work under this grant? For example, "this funding will be used for a feasibility study for shared solar and, if successful, the shared solar project would move forward"; or "this funding will be used to build organizational capacity to plan a multi-lingual outreach campaign for clean energy".*

0/200
What is the current state of development of your proposed idea?*

0/200
(When applicable) If this funding will be used to work towards pursuing another clean energy grant opportunity, please clarify which grant opportunity you plan to pursue and how this EmPower funding would enable the pursuit of that funding.
(If Applicable) If this is a follow-on funding request for a previously awarded project under EmPower, please clarify the following:

Please answer the following questions. Brief responses are encouraged.
How does this follow-on funding support the evolution of your program model or project in a significant or impactful way?

0/200
What, if any, changes have been made to the design of the program to incorporate lessons learned and/or to shift focus or expand the impact of your program model or project?

0/200

Proposed Timeline and Outcomes
With as much detail as currently available, please clarify your expected timeline for the usage of this funding an all proposed outcomes of the funding. Please note that funding should be utilized within 2 years. Be sure to tie in all activities proposed in the previous section about your proposal.*
What would you propose to submit to MassCEC to show completion of the tasks supported by this funding? Possible examples include: a completed feasibility study, a completed grant application, or confirmation of stakeholder outreach including number of participants reached. If selected this will be used to draft your project scope of work and milestones for payment. See example scope of work in template contract (Attachment 3). *

Proposed Budget (Required)
Note: Section 5 is required, even if applying for the up to $50,000.

Proposed funding usage breakout: Please fill out the table below with each activity and proposed amount of funding associated with completing that activity. If there are multiple team members that will receive funding, please list which team member will ultimately receive funds for each budget item. Note: MassCEC will pay all awarded funding directly to the Lead Applicant and the Lead Applicant can disburse the funding to other team members, so be sure to clarify exactly who will receive which funds.

Budget*

	Proposed activity (e.g. funding staff time & supplies for community outreach)	Team member receiving funds for each proposed activity (e.g., the lead applicant or a specific project partner)	Funding amount
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Total Budget Request (up to $25,000)*
In-kind technical services from MassCEC: Depending on the type of program applicants propose, and upon request, MassCEC may offer in-kind support instead of all or part of a cash grant. Are the Applicants interested in any in-kind technical services from MassCEC instead of all or part of a cast grant? Please respond below, and also contact MassCEC to discuss your interests/needs prior to applying.*

NoYes, please elaborate:
Grant Payments: Applicants will receive a portion of the funding upfront and will receive the remainder once part or all of the project is completed. How would you like to receive the rest of the funds?*

In one payment when the tasks supported by this funding are completed.In multiple payments, based on the completion of milestones/other (if you would like to receive multiple payments, please elaborate on how you would prefer to receive the remainder of the funds):
Non-MassCEC Funding (if applicable): Describe any other sources of support (name of grant, organization providing grant) for this proposed work, including in-kind work. When possible, please provide value of funding. (Note: no additional sources of funding are required to apply for this funding.)
Would you like to request up to $50,000 in funding for your proposed idea?

Please note: only a limited number of applications will be funded past $25,000, and applications will be considered on a case-by-case basis. Please review the EmPower FY25 Implementation Grant opportunity first or inquire about your eligibility at empower@masscec.com, and if you are not eligible for an Implementation Grant and believe you require more than $25,000 to acheive the goal(s) of your proposed idea, select yes and continue to submitting a second proposed budget on the next page.
I would like to submit an alternate proposed budget for up to $50,000. (If you select yes, you will be prompted to provide an alternate budget and more information on the next page.)*

YesNo

Proposed Budget up to $50,000 (optional)
Narrative Requesting Additional Funds: Please describe how additional funds would amplify the outcomes of the proposed Innovation and Capacity Building grant.

0/200
Note: Section 5 (above, $25,000 budget submission) is required for all Applicants, including those proposing an additional budget in this section.

Proposed funding usage breakout: Please fill out the table below with each activity and proposed amount of funding associated with completing that activity. If there are multiple team members that will receive funding, please list which team member will ultimately receive funds for each budget item. Note: MassCEC will pay all awarded funding directly to the Lead Applicant and the Lead Applicant can disburse the funding to other team members, so be sure to clarify exactly who will receive which funds.
*Please be sure the total of the funding amount table below is the total amount requested and not an additional amount, e.g. it is $40,000 if that is the total amount being requested instead of a separate $15,000 to be added to $25,000 from the previous page.

Budget (Up to $50,000 scenario)

	Proposed activity (e.g. funding staff time & supplies for community outreach)	Team member receiving funds for each proposed activity (e.g., the lead applicant or a specific project partner)	Funding amount
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Total Budget Request (Up to $50,000)
In-kind technical services from MassCEC: Depending on the type of program applicants propose, and upon request, MassCEC may offer in-kind support instead of all or part of a cash grant. Are the Applicants interested in any in-kind technical services from MassCEC instead of all or part of a cast grant? Please respond below, and also contact MassCEC to discuss your interests/needs prior to applying.

NoYes, please elaborate:
Grant Payments: Applicants will receive a portion of the funding upfront and will receive the remainder once part or all of the project is completed. How would you like to receive the rest of the funds?

In one payment when the tasks supported by this funding are completed.In multiple payments, based on the completion of milestones/other (if you would like to receive multiple payments, please elaborate on how you would prefer to receive the remainder of the funds):

Submission of Attachment 1: EmPower Mass FY25 Innovation and Capacity Building Signature and Acceptance Form
Please visit the EmPower website here, download and sign Attachment 1 for Innovation & Capacity Building Grants, and upload your signed document below.
Upload your signed version of Attachment 1 here. (If you are submitting a draft application and requesting feedback, you can upload a blank document here instead if you wish to wait to upload this form until your final submission.)*

Cancelof

Review of Attachment 3: Sample Grant Agreement & Example Scope of Work and Milestones Table
Please visit the EmPower website here for a sample Innovation & Capacity Building grant agreement, scope of work, and project milestones table.
Have you reviewed the sample grant agreement? Specifically, have you reviewed the example scope of work and milestones table? (Required)*

Yes
Are there any changes to this template contract agreement that would be necessary before the Applicant could sign the contract? (Note: MassCEC has limited ability to change our standard legal contract terms. Please note that reviewing and requesting changes to standard legal contract terms, if selected, will impact timelines for contracting.*

NoYes - if so, please elaborate below and/or provide an annotated version of Attachment 3 with your application (upload below if applicable)
(Optional) Upload your annotated version of Attachment 3 here.

Cancelof
If you have any questions about these documents, please contact MassCEC prior to applying: empower@masscec.com
Should be Empty:

	Has SDO Certification	Meets the criteria but has not completed SDO certification
Minority Business Enterprise
Women Business Enterprise
Service-Disabled Veteran Business Enterprise
Veteran Business Enterprise
Lesbian, Gay, Bisexual, and Transgender Business Enterprise
Disability-Owned Business Enterprise

EmPower Massachusetts FY25 Innovation and Capacity Building Grant Application Form

Contact Information

First Partner

Second Partner

Third Partner

Fourth Partner

Fifth Partner

Sixth Partner

Seventh Partner

Eighth Partner

Ninth Partner

10+ Partners

Experience & Qualifications

Optional DEI Qualification and Statement

Grant Funding Proposal (i.e. Proposed Approach)

(If Applicable) If this is a follow-on funding request for a previously awarded project under EmPower, please clarify the following:

Proposed Timeline and Outcomes

Proposed Budget (Required)

Proposed Budget up to $50,000 (optional)

Submission of Attachment 1: EmPower Mass FY25 Innovation and Capacity Building Signature and Acceptance Form

Review of Attachment 3: Sample Grant Agreement & Example Scope of Work and Milestones Table