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Community Service Fund Application Form

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Community Service Fund Application Form County of Marin Community Service Fund Program Application Date September 25, 2017 Application Form Fiscal Year July 1, 2017 - June 30, 2018 Organization Information Full Legal Name: Marin Athletic Foundation Organization URL: www.marinathleticfoundation.org Mission/purpose of your organization: The mission of the Marin Athletic Foundation is to support Marin County High School athletic programs by focusing on the health, safety, and injury prevention of all student athletes. MAF has established new initiatives that provide students, faculty, and staff with assistance and resources to create a safer athletic experience for everyone. These initiatives include baseline concussion testing, safety equipment and athletic trainers. Grant Request Information Program/Project Name: Health, Safety and Injury Prevention Program Amount Requested Dollar: $10,000.00 Total Project Cost: $1,125,000.00 Description of the proposed project/program, including the proposed project's goal(s), and the nature of the costs in specific terms, i.e. materials, labor costs, etc. Specifics of how the requested County funds will be used. The purpose of the Health, Safety and Injury Prevention program is to ensure that EVERY high school student athlete in Marin County has access to equipment and personnel to ensure a safe athletic experience. Specifically, MAF provides funding to participating high schools, based on need, to purchase impact sensors for helmets ($75,000), soft shell gear ($154,400), baseline concussion testing ($50,000) and athletic trainers ($845,000). The goal is to level the playing field in regards to safety and injury prevention, so that no matter which high school in Marin a student may attend, they are assured the same level of safety. The County funds will be directly used to fill specific health, safety and injury prevention needs as communicated by each high school to MAF. List of all community interests that will be affected by the proposed project/program and the public benefit to be derived from it: The community interests that will be affected by this project include every student athlete at Tamalpais High School, Redwood High School, Drake High School, San Rafael High School, Terra Linda High School, Branson, Marin Catholic High School, Marin Academy, Novato High School, San Marin High School and Tomales High School. It is the founding belief of MAF that athletics are a vital part of every high school experience and provide important educational and developmental outcomes for students. The organization believes that school districts need community support to keep athletic programs safe to ensure that broad participation by all students in both interscholastic and intramural programs continue. The goal of this program is to ensure that that happens. The total amount received for the past three fiscal years: Year Amount Project 2016 - 2017 2015 - 2016 $5,000.00 Health, Safety and Injury Prevention Program 2014 - 2015 No County funding was received for this project or others. Project/program cannot be completed if amount received is less than requested amount of Community Service funds. Applicants are encouraged to leverage funding from other non-County sources, and priority will be given to requests that represent no more than 50% of total project cost. To demonstrate all sources of project funding, including other County sources, please provide a project/program budget below. Please fill in as applicable, and round to the nearest dollar. Project Funding Funding Funding Agency Received Notes Sources Requested County CSF Federal Grant State Grant $0 Individual Community Donations/ This is a letter campaign and golf $0 $48,000 Contributions Golf Tournament tournament Wells Fargo, Other Local Allensby Charitable $7,500 $1,500 Agencies Trust In kind services Ghillotti Brothers, Corporate donations, Hall of Other $53,000 MCAL Hall of Fame Fame Banquet Total Sources $7,500 $102,500 Project Budgeted Spent to Date Notes Expenses Personnel Costs $27,600 $6,900 Services and $7,400 $4,000 Supplies Capital Other $0 Total Expenses $35,000 $10,900 .
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