<p> ETC SMALL GRANTS PROGRAM – APPLICATION</p><p>SECTION 1: COVER PAGE</p><p>APPLICANT NAME: APPLICANT TYPE: ___ORGANIZATION ___INDIVIDUAL ___COLLECTIVE/GROUP CONTACT PERSON: TITLE (IF APPLICABLE): MAILING ADDRESS: EMAIL: PHONE:</p><p>GRANT TYPE (please select one): ___Base grant (up to $500) ___Strength grant (up to $2,500) ___Amp grant (up to $5,000)</p><p>PROJECT TITLE: BRIEF PROJECT DESCRIPTION:</p><p>PRIORITY ISSUE (PLEASE SELECT ONE): During the community planning process, community members identified the following as priority issues that need to be addressed in the neighborhood. Please select one issue that most closely aligns with your proposed project:</p><p> YOUTH SERVICES: Includes recreation, computer literacy, civic engagement, college prep, after school programs, non-violent conflict resolution, youth entrepreneurship, etc.</p><p> EDUCATION: Includes basic life skills, financial literacy, parenting skills, neighborhood and cultural history, etc.</p><p> SAFETY: Includes interventions that address crime, drugs, poor lighting, safety in specific locations, safety in recreational areas, neighborhood clean-up and beautification, etc.</p><p> NEIGHBORHOOD PRIDE: Includes murals, landscaping or tree planting, installation of decorative features or other aesthetic improvements.</p><p> ECONOMIC DEVELOPMENT (All business/entrepreneurship must be in this category): Includes job training, access to employment, local goods and services, entrepreneurship, etc.</p><p>NUMBER OF PEOPLE TO BE SERVED: TOTAL: IN THE ETC NEIGHBORHOOD:</p><p>FUNDS REQUESTED FROM THE ETC SMALL GRANTS PROGRAM: TOTAL COST OF YOUR PROJECT:</p><p>WHAT IS YOUR ORGANIZATION’S ANNUAL BUDGET?:</p><p>1 HOW DID YOU HEAR ABOUT THIS GRANT?SECTION 2: PROJECT NARRATIVE</p><p>1. APPLICANT OVERVIEW (150 words max): Tell us about yourself. If you are applying as an organization, please provide a brief overview of your organization (mission, vision, leadership, structure, year of incorporation, tax status, etc.). If you are applying as an individual or non-incorporated group, please tell us briefly about your background and reasons for applying.</p><p>2. PROJECT DESCRIPTION (300 words max): Describe your project. Be sure to address all of the following questions (in any order):</p><p> What are the activities?</p><p> Why is this project important?</p><p> Who will be doing what? </p><p> Where will the activities take place? </p><p> How many people will be served? How many will be residents of the ETC?</p><p> How will you document that activities take place in the ETC neighborhood, or directly benefit ETC residents?</p><p>3. PROJECT OUTCOMES & OUTPUTS (150 words max): State clearly the tangible, visible results your project will achieve. Wherever possible, please quantify your outputs. </p><p>4. PROJECT IMPACT (150 words max) Please discuss what impact your project will have on the priority issue you identified in Section 1 above, and how it fits into the ETC Plan (see “Overview of the ETC Plan”, attached.) How will you measure this impact? </p><p>5. CHALLENGES (100 words max) Please discuss any challenges you foresee that may impact your ability to complete the project. How will you address them? Note any relevant experience that you/your organization has.</p><p>6. PARTNERSHIPS (100 words max) Please indicate any other organizations or individuals that you will collaborate with on this project, and their role. Are they located within the ETC neighborhood? Note: If a partner’s staff or facilities are integral to the project, please attach a letter of support. </p><p>2 7. BUDGET Please fill out the Budget Form below for your project. List anticipated expenses in detail, including the hours and rates of any staff or consultants. </p><p>Indicate whether any of these expenses will be funded through sources other than this grant. For outside funding sources, please indicate whether the funds are:  “Certain” (you have them, or you have a guarantee that you will get them)  “Probable” (you’ve asked for them and have a reasonable expectation that they’ll come through)  “Requested” (you’ve asked, but have no guarantee you’ll get them). </p><p>Expense Amount Source of funds Status</p><p>Total project cost Requested from ETC</p><p>REQUIRED ATTACHMENTS  For Amp grants: IRS letter verifying 501(c)3 status  Letters of support, if applicable</p><p>OPTIONAL ATTACHMENTS If you like, please submit no more than two pages of materials to give us an idea of your past work and your current project. These can be photographs, news clippings, etc.</p><p>3</p>