Mayor’s Matching Grant Application for Neighborhood Organizations Please complete the following Application Form, answering all questions completely and providing requested supporting documentation and attachments. Incomplete applications, including all required attachments and documentation, will not be considered. Applicant Information Neighborhood organization’s legal name DBA Legal Address Mailing Address President Name Email Telephone Project Leader Telephone Email Website TIN# What year was the neighborhood organization established? How many homes are in the neighborhood organization? Is the neighborhood organization mandatory, which requires all Yes owners to be members and pay dues? If yes, please submit the current and previous year budgets with your application. Alternate Project Leader Information Alternate Project Leader Telephone Email Project Description 1. Name of Proposed Project 2. Amount of City funds requested $ (Grant funds may be requested in increments of $500) No 3. Describe the proposed project or program, including the identified need that the program will address; how neighborhood residents were involved in selecting and planning the project; program/project timeline; volunteer recruitment strategy and partnerships with other organizations or businesses to provide the program. Please be specific. (Not to exceed 1 page) 4. Where will project activities take place? Please provide specific addresses for location(s). For physical improvement projects, please include 2 photos of the current conditions of the project site. 5. How many participants do you anticipate will participate in this project? Adults: Children/Youth: NEIGHBORHOOD COMMUNITY IMPACT 6. What is the intended benefit of the project? Why is it of importance to the neighborhood? (Do not exceed ½ page.) PHYSICAL IMPROVEMENT PROJECTS This section is to be completed only if the project is a physical improvement project. 7. What type of land is the proposed physical improvement project to be constructed on? Public Right of Way Common Area owned by the neighborhood organization Note: Physical improvement projects on private property are not eligible for funding. Neighborhood Sign Projects: 8. If you are applying to implement a neighborhood sign project, the Project Leader and Neighborhood Organization President must sign the following statement: Our neighborhood organization will comply with the City Sign Policy as outlined in the guidelines and eligibility for the City of Orlando Mayor’s Matching Grant for neighborhood organizations. Project Leader Signature Neighborhood Organization President Signature 9. Please provide a detailed description and schedule of how the neighborhood organization will fund and manage the ongoing maintenance of the physical improvement project. 10. Attach a preliminary site plan drawing of the exact site location(s). Did a representative from the neighborhood organization attend an application workshop (required)? Yes No If so, what date: Indicate the name and contact information of the individual who completed this application. Name Phone Number Email Address 5. Signature of the neighborhood organization President who verifies the information contained in the application is accurate and correct and confirms the organization’s application for the Mayor’s Matching Grant. Neighborhood Organization President (Type or Print) Neighborhood Organization President (Signature) Date MAYOR’S MATCHING GRANT PROJECT TEAM Neighborhood Organization: List at least seven neighborhood organization members who will meet at least quarterly to serve as the neighborhood’s Mayor’s Matching Grant Project Team. PRINT NAME AND PROVIDE SIGNATURE PRINT NAME ADDRESS TELEPHONE NUMBER E-MAIL ADDRESS ROLE Project Leader SIGNATURE PRINT NAME Alternate Project Leader SIGNATURE PRINT NAME Reports Coordinator SIGNATURE PRINT NAME Partner and Volunteer Coordinator SIGNATURE PRINT NAME Historian SIGNATURE PRINT NAME Additional Team Member SIGNATURE PRINT NAME SIGNATURE Additional Team Member Application Checklist Instructions: Review the following items to ensure required documents are attached to the application and the application has been thoroughly completed. Incomplete applications will be returned to the applicant. Is a completed W-9 form for the neighborhood organization attached? (Visit irs.gov/pub/irs-pdf/fw9.pdf for a copy of the form) Yes No Is application signed by the proper persons to approve application? Yes No Are all application questions answered thoroughly and completely? Yes No Is a site plan drawing attached (if applicable)? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Do all members of the Project Team reside in the neighborhood where the project will occur? Is a Match Contribution Worksheet Completed, documenting all volunteer, in-kind and cash contributions to the program/project? Are all Letters of Intent forms completed and attached for in-kind and cash contributions? Is a Proposed Budget completed and attached, including a Budget Narrative of expenses? Do all project expenses that exceed $250 per unit cost include at least three estimates from established vendors? Do the minutes from the neighborhood organization meeting reflect all three discussion items noted in application guidelines (including approval of neighborhood identification, signs, if applicable)? Are they notarized and attached to the application? If you are a mandatory organization, did you include a copy of the current and previous years’ budget with the application? Is the neighborhood organization registered with the City of Orlando Office of Communications and Neighborhood Relations? Did a representative from the neighborhood organization attend an Application Workshop?