HomeMy WebLinkAboutHAHC - HopeSource YHDP Match RequestHomelessness and Affordable Housing Funds
2021 Notice of Funds Available Application Form
PROJECT INFORMATION
Project Title:
Project Site Name(s):
Project Site Address(s):
Which fund source is this proposal for? (select one, see Section 1 of the NOFA for details)
Affordable Housing Funds
Homeless and Housing Assistance Funds
Total Project Costs (including other funding and resources):
Total Amount Requested (from Kittitas County Homeless Housing and Assistance or Affordable
Housing funds):
Time Frame for Utilization of Requested Funds:
City, Town or Unincorporated Area to be served:
APPLICANT INFORMATION
Name of Applicant Organization:
Mailing Address:
City, State, Zip:
Phone:
Fax:
Email Address:
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Website:
Federal Tax Identification Number:
Type of Organization:
Government
Non-Profit
For-Profit
Local housing authority
Tribe
PROJECT CONTACTS
Name of Organization Director:
Phone:
Email:
Project Contact Name:
Title:
Phone:
Email Address:
Fiscal Contact Name:
Phone:
Email Address:
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AUTHORIZATION
Acceptance of this application may be subject to subsequent compliance reviews, including a review
of the latest audit of financial statement. Preparation of an application does not guarantee that
applicants will receive funds. By signing this grant application form the undersigned certifies that all
information is accurate to the best of his/her knowledge.
__________________________________ ____________
Signature of Authorized Representative Date
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PROPOSAL DETAILS
1.Applicant Profile and Qualifications: Tell us about your organization including the
purpose of your work, your goals, any history, and experience working in homeless
and/or affordable housing services, experience managing public funds, and anything
else that describes the organization’s qualifications. (250 words max.)
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2.Project Description Summary: Provide a brief summary the project being proposed and
a general description of how it will address homelessness or affordable housing in
Kittitas County. Be sure and indicate whether the proposal is intended to provide direct
client services or construction, maintenance, or improvement of housing facilities,
including a proposed timeline for completion. (300 words max.)
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3.County Priorities: Indicate which of the following priorities are being addressed by the
proposed project and how you intend to address them. (Select all that apply and give
a brief 100 word description for each selected.)
¾Quickly identify and engage people experiencing homelessness.
¾Prioritize housing for people with the greatest needs.
¾Operate an effective and efficient homeless crisis response system that
swiftly moves people into stable permanent housing.
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¾Project the fully implemented local plans on the number of households
housed and the number of households left unsheltered, assuming existing
resources and state policies.
¾Address racial disparities amongst people experiencing homelessness.
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Other information you think would be beneficial for the Committee to know.
4.Partnerships: List your key community partnerships for the proposed project and what
their role will be. (250 words max.)
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5.Gaps and Duplication in Services: Describe how your proposed project fills a gap in
homeless and/or affordable housing services in Kittitas County. Include a description of
how the project is or isn’t a duplication of current services. (250 words max.)
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6.Sustainability: Describe your ability, experience, and resources to implement and
sustain the project during the term of the project. (250 words max.)
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7.Goals & Objectives: Use the Goals and Objectives Form below to fill in the following
table with your project’s goals, measures, strategies, and objectives. See the examples
below for guidance and use as many forms as necessary.
Example #1:
GOAL: Increase number of people enrolled in health insurance by 25% by December 31, 2020.
Measures (How will you know you are making progress toward your goal?) Data Source
Number of new enrollees in health insurance Internal tracking
sheet
Strategy #1
(What will you do to achieve your goal?)
Create promotional materials to distribute to local partners
advertising health insurance enrollment assistance.
Measurable Objectives:
Promote the service with at least 5 community partners
each quarter through December 2020.
Distribute at least 100 flyers around the community by
December 2020.
Strategy #2
(What will you do to achieve your goal?)
Offer health insurance enrollment assistance at local
community events.
Measurable Objectives:
Attend at least 2 community events per quarter in both
Upper Kittitas County and Lower Kittitas County through
December 2020
Strategy #3
(What will you do to achieve your goal?)
Offer health insurance enrollment assistance appointments in
the office.
Measurable Objectives:
Schedule at least 40 hours per month of open walk-in
assistance through December 2020.
Ensure staff availability for at least 25 scheduled
appointments each month through December 2020.
Example #2:
GOAL: Increase the number of trail systems available to the general public within the City of Ellensburg from 5
to 7 by December 2021.
Measures (How will you know you are making progress toward your goal?) Data Source
Number of trail systems open to the public and clearly labeled Trails report
Strategy #1
(What will you do to achieve your goal?)
Establish public-private partnerships for funding trail
construction and maintenance.
Measurable Objectives:
Create tailored presentation about project by March 2020.
Meet with at least 2 potential partners each quarter
through June 2020.
Establish at least 2 primary public-private partnerships for
trails by December 2020.
Strategy #2
(What will you do to achieve your goal?) Identify sites for new trail systems.
Measurable Objectives:
Conduct site visits with partners of potential new sites by
March 2021.
Identify pros and cons of potential new sites by June 2021.
Solidify 2 new trail sites by December 2021.
Strategy #3
(What will you do to achieve your goal?) Build new trail systems.
Measurable Objectives:
Create plans for construction of new trail systems by March
2021.
Two new trail systems will be built by December 2021.
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GOALS AND OBJECTIVES FORM
Fill out white sections only.
GOAL:
Measures (How will you know you are making progress toward your goal?) Data Source
Strategy #1:
(What will you do to achieve your goal?)
Measurable Objectives:
Strategy #2:
(What will you do to achieve your goal?)
Measurable Objectives:
Strategy #3:
(What will you do to achieve your goal?)
Measurable Objectives:
*Use copies of the same form if you have more than 3 strategies for the same goal*
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BUDGET NARRATIVE
1.Funding Utilization: Describe how the funds will be used to support the proposed
project. For example, will the funds be used for staff time, supplies, consultants,
contractors, construction costs, direct customer services, etc.? (250 words max.)
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2.Other Support: Describe any monetary, in-kind, donations, grants, or other types of
support that will be used for the project. Include both guaranteed support and support
that may still be uncertain. (250 words max.)
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3.Sustainability: Describe how this project would or wouldn’t be sustained if these
Homelessness Prevention and Affordable Housing funds were not available either
currently or in the future. (250 words max.)
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4.Partial Funding: If this project were to receive only partial funding from this source,
how would the project be impacted? How would the proposal be adjusted for less than
the requested amount of funds? (250 words max.)
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