FY2019 Wayne Metro Seeding Wayne County
Page 1
Please complete the application in its entirety. Applications are due by 4:00 PM on December 14, 2018
Organization Name:
501(c)3 Entity
Yes
No
501(c)3 ID Number
(Being used for application)
Must submit IRS designation letter as proof of 501(c)3 status
Street Address
City:
Zip Code:
Phone Number:
Email
Fax Number
Amount of Organization's Annual Operating Budget
Executive Director (ED) Name
Email
Page 2
Contact Person for Proposal
Phone Number
Email
Project Name:
Amount Requested:
Check
ONE
Eligible Program Area
Employement
Health and Nutrition
Youth and Adult Education
Neighborhood Improvement
Check
ONE
Regional Advisory Council (RAC) representing your primary service area. SEE RAC MAP FOR MORE DETAILS on our website at
https://www.waynemetro.org/get-involved/
RAC 1
RAC 2
RAC 3
RAC 4
RAC 5
RAC 6
Page 3
Did the organization receive Seeding Grant funds in 2018
YES
NO
If yes:
Amount $:
Project Name:
Purpose
1. Brief history and purpose of your organization. Include mission and current goals.
2. Describe project or initiative you are seeking funding to support.
3. Describe specific items for which you are seeking funding and why they are needed for project:
4. What is the service area of the project?
(Include city, neighborhood and zip code)
5.
Please list below how many adults,children (under 18 years), and / or families will be served with the requested funding amount during the grant period of March 15, 2019 to August 30, 2019.
Please click
here
, complete and upload the budget form, checklist, and ALL applicable attachments form using the Choose File button below.
All attachments must be in a single PDF and checklist must be printed and signed by the Certifying Official.
Contact Information