Mid County Neighborhood Initiative Mini Grant Application



  1. One Page Cover Sheet (containing the following information)

Organization Name

Organization Type: ___ not for profit; _____ community or civic; _____ government

Address

Telephone and Fax Number

Web Address and/or Email Address

Director and/or Contact Person

Grant Request $

Grant Period: March 1, 2003 through June 30th, 2003

Project or Program Title:

Summary of project or grant request in two or three sentences

Original Signature of Person Authorized to Act on Behalf of the Organization (blue ink)


  1. Brief Narrative (No more than five pages, no attachments of any kind)

    1. Introduction and Background


    1. Description of Proposed Request



  1. Budget (Use the provided format to submit your budget)


Budget for the period through June 30th, 2003


Item

Expenses

Salaries and Wages

Amount

FT/PT

Ex. Coordinator

$

FT

Ex. Assistant

$

PT


$



$



$


Fringe Benefit and payroll taxes

$

Consultant & Professional Fees

$

Travel

$

Equipment

$

Program/Office Supplies

$

Other (please specify)

$



Total Expense

$





















Guidelines for applicants


Proposals are due February 28th, 2003 at 3:00 p.m.

Proposals must have a completed cover sheet with original signature, narrative, and budget to be accepted and considered.


Use a standard black typeface no smaller than 12 points, single spaced text and single sided letter sized-paper. Put page numbers on each page. Staple the proposal in the upper left hand corner.


Proposal must be delivered to the Mid-County Regional Services Center, 2424 Reedie Drive, to the attention of:


Stephanie Jennings, Mid County Neighborhood Initiative Project Coordinator

Email: Stephanie.Jennings@co.mo.md.us

Phone: 240-777-8114


Melodye L. Watson, Program Monitor

Email: Melodye.Watson@co.mo.md.us

Phone: 240-777-4379


For technical assistance on completing this grant application, contact the following Montgomery County Collaboration Council for Children, Youth, and Families personnel: Stephanie Jennings, Mid County Neighborhood Initiative Project Coordinator or Melodye L. Watson, Program Monitor.