Youth and Crime Prevention
Application Form
FY 2013 Juvenile Justice and Delinquency Prevention
Federal Formula Grant
Program Area: Disproportionate Minority Contact
Application Due Date: 11:59 p.m. PDT, June 21, 2014
Oregon Youth Development Council
255 Capitol Street NE
Salem, OR 97301-0203
Application Cover Sheet
Project Name:
Contact Person:
Affiliation:
Address:
Phone Number:
Email:
Grant Amount:
Please provide a project name
Please provide a contact person, their affiliation, address,
phone number, and email.
$52,000
Note: One grant in the amount of $52,000 will be awarded for a selected project,
beginning September 1, 2014 and ending August 31, 2015.
Project Summary: (no more than 200 words)
Application Checklist
Be sure to include each of the following in the final community application:
1. A completed application cover sheet
2. A completed narrative not to exceed 5 pages
3. A completed OJJDP logic model
4. Budget and budget detail
5. Federal standard assurances
6. Federal certifications
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 1 of 6
NARRATIVE
Community Need (25 points)
Indicators of Need
Include data and analysis to make a persuasive case for the need for the proposed program and
the target population. It should be apparent from the data provided that the need exists and
there is sufficient explanation of the data, including an analysis of trends and contributing
factors, including assessment of specific minority groups and decision points in the juvenile
justice system to be targeted in the project. Relevant local data for the proposed geographic area
are used wherever possible. Data sources are provided.
Please reference OJJDP DMC manual https://www.ncjrs.gov/html/ojjdp/dmc_ta_manual/
Equity (25 points)
1. Community Participants Reflective of Population
Are the organizations and individuals involved in the project reflective of the
population in need of programs and services in the community?
2. Culturally Appropriate Activities
Is the proposed project culturally and gender appropriate for the population to be
served?
3. Disparities in Outcomes
Are the efforts structured to specifically address disparities in outcomes seen between
youth?
Partnerships or Collective Impact (15 points)
Strong applications will demonstrate participation in a Collective Impact approach or
coordination of the program with the work of other community organizations may be evident
and submitted.
Program Plan: Description and Logic Model (50 points)
The project description is clear and described in sufficient detail so that it is understandable to
the reviewer. Expected project accomplishments are stated, are reasonable and the objectives fit
with the target population. The proposal specifies that the project is clearly designed to
implement prevention activities, program delivery, and systems change activities to address
and reduce DMC level within specific minority groups in a targeted jurisdiction. The logic
model lists objectives, activities, and output measures and short-term and long-term measures.
The logic model includes target figures. The logic model identifies the federal Formula Grant
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 2 of 6
program area. It includes the mandatory output and outcome measures and at least two
additional output and outcome measures. Outcome measures align with program objectives
and Evaluation Plan. It is clear that data sources will be available for collection as needed for
outcomes and outputs reporting. A timeline is provided with a realistic implementation
schedule that identifies tasks and responsible parties.
Application must include a logic model that indicates objectives, activities, outputs and
outcomes. There are some specific federal requirements that are unique to the Formula Grant
programs. OJJDP provides a menu of outcome and output measures to use. Applicants must
plan to address all required measures and must choose at least two additional output measures
and two additional outcome measures from the menu provided. To locate this essential
information, follow these instructions:
1) Go to https://www.ojjdp-dctat.org/help/program_logic_model.cfm?grantiD=3
2) Select the Disproportionate Minority Contact Standard Program Area (Area #10)
3) Open the associated Performance Measures Matrix.
4) On the Performance Measures Matrix, find the required measures, which are in bold
face and capitalized. You must track those measures.
5) From the matrix, select additional output and outcome measures that you also will
track.
Budget and Sustainability Plan
Complete the Program Budget Summary form and attach a budget detail narrative that explains
the proposed costs. Provide a plan to sustain this program beyond the current fiscal year.
Budget narrative explains and justifies requested funds and matching funds. Evidence of local
partnerships and commitment is described (up to 25% of total cost).
*Note: Budget and sustainability plan can receive a maximum of 10 points and will be scored
as part of the Logic model Category.
Federal Assurances and Certifications
Please complete and sign federal assurances
http://ojp.gov/funding/forms/std_assurances.pdf and certifications
http://ojp.gov/funding/forms/certifications.pdf forms.
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 3 of 6
OJJDP FORMULA GRANT LOGIC MODEL
The logic model should lay out the logical relationships between the program’s objectives,
activities, outputs, and outcomes. It is a description of how the program will work to achieve
benefits for participants, staff, and the community.
Federal Formula Grant Program Area #10: DMC
Goal/Obj
ective
Strategy/
Activity
Outputs
Mandatory
Measures
Two
Additional
Measures*
Short-term Outcomes
Long-term Outcomes
Mandatory
Measures
Mandatory
Measures
1 -2
Additional
Measures*
1 -2
Additional
Measures*
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 4 of 6
* In addition to the Mandatory Measures, one or two additional output measures and one or
two additional outcome measures must be selected. The additional outcome measures can be
either short-term or long-term.
BUDGET CATEGORY
FORMULA
GRANT
MATCHING
FUNDS
TOTAL
AMOUNT
Round all numbers to nearest whole dollar.
A. Personnel
Attach detail that lists each position by title,
percentage of time devoted to the project or
FTE, and annual salary / hourly rate.
B. Fringe Benefits
Attach detail for fringe benefit costs and
payroll taxes for each Personnel position.
C. Travel
Itemize anticipated travel expenses on the
next page. Identify purpose of the travel.
D. Equipment
Equipment is tangible personal property
costing over $5,000 and having a useful life of
more than one year. Attach detailed
information for any equipment to be
purchased.
E. Supplies
Supplies are items with a useful life of less
than one year. Attach detailed description.
F. Consultants/Contracts
Provide a brief description of the services to
be provided, the hourly/daily rate, estimated
time on the project and method of
procurement. Consultant fees cannot exceed
$450 per 8-hour day.
G. Other Costs
Provide detail for costs that do not fit in the
above categories.
H. Grant Administration
A maximum of 10% of the Formula Grant can
be used for costs associated with the
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 5 of 6
BUDGET CATEGORY
FORMULA
GRANT
MATCHING
FUNDS
TOTAL
AMOUNT
Round all numbers to nearest whole dollar.
Applicant’s administration of the grant funds,
including indirect costs.
Subtotal: Direct Costs
I. Indirect Costs
Include in the Formula Grant column only if the
Applicant has a current indirect cost rate or
allocation plan approved by a Federal cognizant
agency.
The total of grant funds requested for Indirect
Costs plus Grant Administration (Line G) cannot
exceed 10% of the requested grant.
TOTAL PROJECT COSTS
(Sum of Direct + Indirect Costs)
BUDGET DETAIL
1. Matching Funds
Identify the source(s) and amount(s) and timing for use of all matching funds included in the
Budget Summary.
2. Line Item Detail
Provide information identified on the Budget Summary form.
3. Sustainability Plan
Youth and Crime Prevention Formula Grant – DMC Application Form
Federal Fiscal Year 2013
Page 6 of 6