Grant Submission Form
Applications:
Applications must be approved by local leadership prior to submitting. Please submit this form 14 days in advance for Mission Support review and approval. Proposals sent in with less than 1 week to review cannot be guaranteed completion by due date. REQUIRED DOCUMENTS: Grant Proposal, Budget Document with details, Copy RFP/Application Instructions.
Amendment/Extension:
When submitting an Amendment/Extension, ensure that all appropriate documentation and a detailed explanation is provided via the attachment or the comments section. Please allow for a 14 day turn around for processing.
Award Documents:
Submit all documents associated with the grant award upon receipt. Please include information in the comments section for any specific details necessary (i.e. wet signature, physical copy required, blue ink, email copy sufficient, etc.). The Mission Support Center will route to the appropriate signatory and send back once signed. Including: Letter/Notice of Award, Certifications and Assurances, Contracts, requests for copies of 990's, audit documents or policies, etc.
Requester Name
*
Today's Date
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Month
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Day
Year
Date
State
*
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Location Code
Has your leadership reviewed and approved?
*
Yes
No
Has your Regional ED for your territory reviewed?
*
Yes
No
MADD Project ID
*
Please reach out to your Accountant to get project ID.
Type of Application Funding Request
*
New Grant (Funding MADD is currently not receiving.)
Renewal (A renewal of existing program funding for one or more additional budget period(s) that would otherwise expire.)
Foundation Grant
Amendment (Budget only)
Amendment (Programmatic only - changing deliverables of the grant)
Extension
Notice/Letter of Award - including those with no actionable items
Grant Award/Contract- Signatures Needed
Grant Award- Fully Executed (Countersigned, Completed)
Grant Support Documents (Terms & Conditions, Grant Assurances, etc.) - Signatures Needed
Name of Granting Agency
*
Requested Amount
*
Awarded Amount (Only include when submitting Award Documents)
Type of Grantor
*
Government
Foundation
Non-Federal
Corporation
Other
Please provide instructions on how the document is submitted to the grantor:
How is the document submitted to the grantor:
*
Online Website
Email
Mail
Other
Date Submission is Due to Grantor
*
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Month
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Day
Year
Date
Grant Start Date
*
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Month
-
Day
Year
Date
Grant End Date
*
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Month
-
Day
Year
Date
Grant Renewal Date (if known)
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Month
-
Day
Year
Date
Documents required by Grantor:
Certificate of Insurance
Board Matrix
IRS Determination Letter
Board Resolutions
Other
Match Required
*
Yes
No
Match %
Is Laptop or Computer being include in grant budget
Yes
No
If yes above, does grantor require made in America?
Yes
No
Web Address for Funding Agency
Please work with your accountant to ensure they are set up with credentials.
Name of Grant Monitor
If applicable.
Contact Information for Grant Monitor
If applicable.
Which programs are associated with this grant.
*
POY
POP
POM
Promposal
Victim Services
Court Monitoring
Law Enforcement Support
TOOFS
LER
Media
Other
Name and Description of Project
Any instructions we need to keep in mind? (Including specifications around signature pages, specific documents being requested by the grantor, etc.)
*
Grant Proposal and or Application
Browse Files
max file size for each file is capped at 100MB
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Budget Documents/Budget Amendment Documents
Browse Files
max file size for each file is capped at 100MB
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of
Copy of RFP/Application Instructions/Financial Guide
Browse Files
max file size for each file is capped at 100MB
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of
Grant Award Documents Only
Browse Files
max file size for each file is capped at 100MB
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of
Submit
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