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Grant Review Form
1. Grantor:
2. Grant ID/Name:
3. CFDA #, if applicable:
4. Anticipated Grant Start Date:
5. Anticipated Grant End Date:
6. Grant Amount Applying For:
7. Brief Description of Grant:
8. Brief description of the need for the project that the grant will be funding:
9. Is there a match requirement? Yes ☐ No ☐ If so, how much? :
10. Have the grant related expenses been budgeted for? Yes ☐ No ☐
11. Minority Impact Statement:
Census Tract Minority Population: Choose an item.
Summarize Positive/Negative Impacts:
If there is a negative impact, please explain the reason for proceeding with this grant:
12. Grant Project Manager: