ecwandc application summary sheet june 2008

7/30/2019 ECWANDC Application Summary Sheet June 2008

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APPLICATION SUMMARY SHEET

(50 WORDS OR LESS):

:

: please describe (a) the intended participants and beneficiaries including the projectednumber of participants; and (b) how the public or NDC will benefit from the project

Yes No

MS.

MR.

(must be different than head of org): MS.

MR.

If not a non-profit – please list at least five ECWANDC Stakeholders participating in/supporting the proposed project .

Effective 4/8/09



ECWANDC APPLICATION FOR FUNDING – continued

$ $ $

[1] : please provide: (a) a brief description of the mission or history of the group; (b)its relationship or role in the ECWANDC area.

[2] : please provide the names including the contact information of the individuals and/ororganizational partners both inside and outside ECWANC area and a brief description of their role in and financialcontribution to the project. Provide letters of support and/or collaboration with other community groups etc., if

applicable in the attachment section.

[3] : please provide: (a) description of the project; (b) a brief history or justification for theproject. (c) the goal(s) and objectives for the project; (d) the plan for outreach and informing the community; and(e) how the contribution of the ECWANDC will be acknowledged.

[4] : please provide a list of the major steps to be taken and corresponding timeline that clearlyshows when each phase of the project will be completed.

[5] : Please provide a detailed budget delineating the following information: (a) the total budget includingall anticipated income and expenses including materials and resources needed to accomplish the project; (b) theportion or dollar amount for items or services requested from the NDC; and (c) a list of the source and dollaramount of the matching funds, value of volunteer hours or other non-cash contributions to satisfy the match

requirement. Include written proposals from sub-contractors, vendors, documentation of matching funds, etc., inthe attachment section. Multiple estimates are not required, but are encouraged. Purchases and subcontract withvendors within the ECWANDC area are also encouraged.

[6] : provide a brief explanation of each item listed including unit cost, number of units.

As a condition of funding, all projects approved for funding are required to:

• Submit a brief (no more than 1 page) report and evaluation to the NC within 45 days of the completion of theevent describing: outcome of the project; completion date; number of persons that participated in the event, list of partners and/or contributors, volunteer hours completed and pictures of the completed project or event. Also

attaché a copy of the program, press release or any outreach or promotional materials• A final accounting to the Treasurer, clearly showing all of the income and expenses, including sources of incomeand details of expenses

, I agree to the terms of the ECWANDC and City of Los Angeles DONE guidelines and procedures. I also acknowlethat the information submitted in this application is accurate to the best of my knowledge. Submitting an application with misleading

information may be cause for disqualification.

2



ECWANDC APPLICATION FOR FUNDING – continued

FOR ECWANDC INTERNAL USE ONLY

Area 1 Area 2 Area 3APPLICATION CHECKLIST (check if completed)

Proposal Summary SheetProject NarrativeBudgetBudget Justification

At least 1bid for any and all purchasesVerification of match – a letter or evidence of

matching funds and volunteer commitmentsPictures or schematic drawings if applicableLetters of Support (optional)

Meets definition of eligible stakeholder organization

Allowable Cost

Includes at least 25% match

Includes at least one estimate for each expense item

Declined/Org Ineligible

Declined/Ineligible Request

Declined/Incomplete after 2 request for information

Declined/Applicant not Present at Meeting

Application Complete/Scheduled forGeneral Meeting on _______________

Approved requested amount

Approved revised amount = $ ____________

Approved modified request (see comments)

Declined

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ecwandc application summary sheet june 2008

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