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Name of Project:
Name of Neighborhood Association:
Name/Address/Phone Numbers of Con tact
Per sons:
Location of Proposed Project:
Location is: Public property
____
Private property ____
School District property ____
Amount of Funds Requested:
$
Time Period of Proposed Project:
From: To: _______
Briefly describe the activities (meetings, newsletters, events,
participation in the Neighborhood Council, etc.) of the neighborhood association over the past 12 months:
Add additional pages if necessary.
Describe the project; why is it needed
and what are its goals :
Add additional pages if
necessary.
C. General List and Description of Activities with estimated time line:(please indicate if this project will or could be phased over a number of years)
Add additional
pages if necessary.
D. List the names of potential resources (neighborhood and other) that will be utilized in this project:
Type
Status
Volun teer
Cash
Anticipated
Committed
1.
2.
3.
4.
5.
Page 2
PROGRAM FOR IMPROVING NEIGHBORHOODS
E. Describe the process used to solicit neighborhood input into this funding request and summarize results:
Add additional pages
if necessary.
F. Does this project benefit low-income, elderly, youth or other disadvantaged youth? If yes, please explain:
Add additional pages if necessary.
G. Could
the project occur without PIN funding?
Add additional pages if necessary.
H. Could the project operate with less funding?
Add additional pages if necessary
EXPENSE CATEGORY
PIN FUNDS
OTHER FUNDS
LIST SOURCE OF OTHER FUNDS
I. Equipment/Supplies
$
$
J.
Project Materials
K. Professional Services
L. Contracted Improvements
M. Other Costs(List)
TOTALS
$
$
$
ADD ADDITIONAL PAGES
TO PROVIDE DETAILS OF BUDGET
Please note
Submission of an application for funding through the Program for Improving Neighborhoods Grant Program
does not guarantee any level of funding