Application: CCF EJ/CJ Fund to Bring Federal Funding to NYC Neighborhoods

Please complete and submit this form by midnight, Wednesday, January 17, 2024.

Cover Page

1. Organization

1. Organization

Organization Name

If you are applying as a partnership, please list the lead organization which would receive funds if grant is awarded.

Organization Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

If this is a partnership, please list up to 4 organizational partners here:

Include the following for each partnership listed: 1. Organizational Name, 2. Primary Contact, and 3. Primary Contact Email.

Applicant Contact Person

Applicant Contact Person Email

Applicant Contact Person Phone

2. If you will use a fiscal sponsor to receive a grant

2. If you will use a fiscal sponsor to receive a grant:

Fiscal Sponsor Name

Fiscal Sponsor Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Fiscal Sponsor Contact Person Email

Fiscal Sponsor Contact Person Phone

3. Project Summary

Please provide 1-2 sentences to describe your project (e.g., we will use CCF funds to hire a fundraiser to enable # partner organizations working together to apply for a $ million EPA Community Change grant. The federal funds will enable us to complete plans for xyz project in x neighborhood).

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Community Need

4. Briefly describe your community, including population, and summarize the major ways it has been impacted by racial and economic inequities and environmental injustice as it relates to the proposed project.

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Proposed Project(s) to Benefit from Federal Funding

5. What are the 1-5 outcomes you hope to achieve with federal funding?

6. Describe your project plan. If you get the federal funding you seek, what will you do? Please include your timeline.

7. Describe how you have engaged and will engage your community in developing and implementing your project/plan

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Anticipated (Hoped For) Federal Funding Sources and Amounts

8. Will you be using CCF funds to help you apply directly for federal funding, apply for subgrants from private or public organizations that received federal funds or advocate for City/State governments to apply for and invest federal funds in your community? Check all that apply.

Apply directly to federal
Apply for subgrants
Advocate for public investment
Other

9. If applying directly for federal funds, to which agency? Which program? For how much? List up to four:

9. If applying directly for federal funds, to which agency? Which program? For how much?

Entry 1

Entry 2

Entry 3

Entry 4

10. If applying for subgrants, list up to four anticipated funders, e.g., Thriving Communities Funder, a City or State agency receiving Federal funding, or other, program, amount.

10. If applying for subgrants, list up to four anticipated funders, e.g., Thriving Communities Funder, a City or State agency receiving Federal funding, or other, program, amount

Entry 1

Entry 2

Entry 3

Entry 4

11. If you are using CCF funds to support advocacy to leverage funding from city and/or state government, which agencies, for what purpose? Amounts, if known? List up to four:

11. If you are using CCF funds to support advocacy to leverage funding from city and/or state government, which agencies, for what purpose? Amounts, if known?

Entry 1

Entry 2

Entry 3

Entry 4

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Request to Change Capital Fund

12. Amount of Request to Change Capital Fund

Type in numbers only, or use arrows.

13. How will you use CCF funds to leverage federal funds? E.g., hire a grant writer, a coalition coordinator, consultant to prepare a feasibility study, other?

14. If you plan to use CCF funds to retain consultants, have you identified the consultants you will retain?

Yes
No

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Project Team Capacity & Community Connections

15. Please describe the capacity of the key organizations applying for this grant including partner organizations and key individuals and their intended roles. Please indicate how your organization's leadership represents the community it serves.

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Required Attachments

Click here fore sample Budget Format

16. CCF Grant Budget

Click or drag a file to this area to upload.

Attach a budget for use of the proposed grant. List key positions, consultants and overhead expenses (add rows to itemize). Please also Include a list of other sources of funding for the proposed project operations, if any.

17. Current Year Organization Budget

Click or drag a file to this area to upload.

Attach your organization's current year budget.

18. Project Budget (if relevant and available)

Click or drag a file to this area to upload.

Please attach a budget for the project for which you are seeking federal funding.

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Cover Page

Community Need

Proposed Project(s) to Benefit from Federal Funding

Anticipated (Hoped For) Federal Funding Sources and Amounts

Request to Change Capital Fund

Project Team Capacity & Community Connections

Required Attachments

Funders