Measure R & U - Approved Multi-Year Programs

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Annual Application for Approved Multi-Year Programs

This form is for programs that have been awarded Multi-Year Measure U Grant Funding and are entering Year 2 or Year 3 of the three-year Multi-Year Funding Award. Reporting requirements for prior years must be met in order to receive committed funds.

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Contact Information

Point of Contact *

Title *

Email *

Phone *

Are the Business address and Mailing address the same? *Grant agreements will be sent to the mailing address listed here. Please verify it is correct to avoid any delay in payment. *

Yes

No

Business Address *

City *

State *

Zip Code *

Mailing Address *

City *

State *

Zip Code *

Website and/or Social Media

Would you like a copy of your application emailed to you? *

Yes

No

Please enter your email address. A copy of this application will be emailed after submission.

Program Information

Organization *

Performance Period *

Program Is In *

Name of Program *

Program Description and Purpose *

Deliverables for this Program
Please list concise and measurable program deliverables in one to two sentences. (S.M.A.R.T. Goals - Specific, Measurable, Achievable, Relevant, Timely) *You will need to state how each deliverable has been met when completing Progress and Performance Reports.

Deliverable 1: *

0/1000 characters

Deliverable 2: *

0/1000 characters

Deliverable 3: *

0/1000 characters

Do you have additional Goals/Deliverables? *

Yes

No

Deliverable 4:

Do you have additional Goals/Deliverables?

Yes

No

Deliverable 5:

How many program participants are anticipated for this year?

Attendees - Locals *

Attendees - Visitors *

Volunteers *

Paid Staff *

Organizers *

Are all special permits, permissions, insurance and requirements of this program still in-place and current? *

Yes

No

Please explain.

Do the programs and locations continue to meet ADA requirements? If no, please explain how to the best of your ability, you will meet these requirements? (Resource: https://www.ada.gov/effective-comm.htm) *

Program Budget

Measure U Funding Committed to This Performance Period: *

Upload the program budget here.

*This is the anticipated budget for the performance period you are applying for (July - June).

*This is the budget specifically for the Measure U funded program(s) within your organization.

*You will have the opportunity to upload your organization's overall budget below.

Program Budget *

Please itemize the Measure U expenses and required match. (Two decimal places)

*Review match requirements in the Application Guide.

*Documentation will be required for Progress and Performance Reports (reciept, timecard, invoice, payroll, etc.).

Expense 1:

Description of Expense *

Total Amount Expense 1 *

Amount: Measure U *

Amount: Cash Match *

Amount: In-Kind *

Total:

$0.00

Expense 2:

Description of Expense

Total Amount Expense 2

Amount: Measure U

Amount: Cash Match

Amount: In-Kind

Total:

$0.00

Expense 3:

Description of Expense

Total Amount Expense 3

Amount: Measure U

Amount: Cash Match

Amount: In-Kind

Total:

$0.00

Expense 4:

Description of Expense

Total Amount Expense 4

Amount: Measure U

Amount: Cash Match

Amount: In-Kind

Total:

$0.00

Expense 5:

Description of Expense

Total Amount Expense 5

Amount: Measure U

Amount: Cash Match

Amount: In-Kind

Total:

$0.00

Total Expense:

0.00

Total Measure U: 🛈

$0.00

Total Cash Match:

0.00

Total In-Kind:

0.00

Total Cash Match + In-Kind:

$0.00

Is the Cash Match + In-Kind ≥ Measure U? *

Is the Cash Match ≥ 50% of the total match? *

STOP! The amount of Measure U Funding awarded must be matched 1:1 with Cash Match and In-kind. In-kind may not be greater than 50% of the match.

If you have additional expenses, please list the amount and description on a separate document and upload here.

Financial Information

Organizations tax status. *

Federal EIN number or ID number: *

Please specify Organization tax status.

Please attach the following financial documents:

Organization Current Year Budget *

Organization Prior Year Budget Actuals (P&L) *

Organization Most Current Tax Return/990 Form