Youth Career Pathways Initiative

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ATTENTION: Please be sure to review all information in the Youth Career Pathways Initiative RFP prior to beginning this form. The RFP includes detailed instructions for this application.

This is a 2-step submission. You will be asked to review your work before submitting your application.

Organizational Information

Organization Name

Organization's EIN #

Do not include special characters such as dashes. This field only accepts numbers.

DUNS Number (if applicable)

Year Incorporated

Total Organizational Budget

Do not include dollar sign or commas.

Street Address

City

State

Zip Code

Phone

Today's Date

Number of active volunteers currently managed by organization

Number of hours contributed by current volunteers

Number of volunteers currently managed for youth programming

Number of hours contributed by volunteers for youth programming

Number of youth served by agency

Youth Career Development Initiative Program Information

Project Title

Program Contact Person - First Name

Program Contact Person - Last Name

Title

Phone

Program Contact Email

A copy of your submission will be sent to this email address.

Geographic Area Served by the Project

Estimated Number of NEW volunteers for youth programming

Volunteers that have not engaged with the organization prior to the project.

Estimated Number of total volunteers that will be impacted/managed through this grant

Total number of volunteers includes new and existing volunteers.

Estimated Number of NEW youth served by proposed program

Youth that have not engaged with the organization prior to the project.

Amount requested for this project

Applicants may request up to $20,000. Do not include dollar signs or commas.

Amount proposed as match for this project

Applicants must propose at least a dollar for dollar match. Do not include dollar signs or commas.

Have you received a prior grant from MSA?

YesNo

Page 2

Executive Summary (150 word maximum)

Project Proposal Narrative

Background / History of Organization (400 word maximum)

Fiscal and Programmatic Oversight (300 word maximum)

Community Need (300 word maximum)

Program Design and Development (1,400 word maximum)

Performance Measures and Evaluation (400 word maximum)

Attachments

Please refer to the Budget Summary and Budget Narrative Forms provided in the RFP.

Budget Summary & Narrative Form

Most recent audit or 990

501(c)(3) letter (or equivalent)

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Contact Information