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2. Applicant - Neighborhood Association or Dubuque non-profit oganization *
4. Project Name*
6. Project Start Date*
   Project Start Date
7. Project End Date*
   Project End Date
9. Organizational Mission Statement (briefly explain what your group does and why)*
11. Project Leader/Grant Contact*
12. Email*
14. Phone Number*
15. Address1*
17. City*
18. State*
19. Zip*
21. Additional Contact
22. Email
24. Phone Number
26. Please check the location(s) or service area(s) for your project*

    1. Downtown
    2. Point Neighborhood
    3. North End
    4. South End

    1. Hill/College
    2. West End
    3. City Wide
    4. Other
28. Which one of the City Council's Goals does your project best address? Choose only one.*
    -- Select One --Robust Local Economy: Diverse Businesses and Jobs With Economic ProsperityVibrant Community: Healthy & SafeLivable Neighborhoods and Housing: Great Places to LiveFinancially Responsible, High Performance City Organization: Sustainable, Equitable and Effective Service DeliverySustainable Environment: Preserving and Enhancing Natural ResourcesPartnership for a Better Dubuque: Building our Community that is Viable and EquitableDiverse Arts, Culture, Parks and Recreation: Experiences and ActivitiesConnected Community: Equitable Transportation, Technology, Infrastructure and Mobility
30. Targeted Planning and Outreach*

    Identify whether you plan to involve any of the following populations in your planning, marketing, outreach process.

    1. Ages under 18
    2. Ages 18-21
    3. Ages 22-30
    4. Ages 31-40
    5. Ages 41-50
    6. Ages 51-60
    7. Ages 61 and over
    8. American Indian/Alaskan Native
    9. Asian
    10. Bi-Sexual
    11. Black/African American

    1. College Students
    2. English Language Learners
    3. Gay
    4. Heterosexual/Straight
    5. Hispanic/Latinx
    6. Immigrants
    7. International Students
    8. Lesbian
    9. Men
    10. Middle class/income
    11. Multi-Racial

    1. Native Hawaiian/Other Pacific Islander
    2. Persons with Disabilities
    3. Refugees
    4. Trans or Transgender
    5. Unemployed/Fixed Income
    6. Upper Class/Income
    7. Veterans
    8. White/Caucasian
    9. Women
    10. Working Class/Income
    11. Our process was non-targeted
32. 1. Please describe your project. Be as specific as possible and address each question. a. What is your project? b. Who will benefit from your project? c. How will you implement your project (include timeline, process and people)? *
34. 2a. Does your project address one or more of the funding priorities? Check all that apply. *

    1. Identify and/or build upon neighborhood strengths and assets
    2. Address needs of low-and-moderate income residents
    3. Support neighborhood development and improve quality of life
    4. Supports efforts to make Dubuque a more equitable and inclusive community
    5. None of the above
35. 2b. Tell us how your project addresses each of the principle(s) checked to the left. *
37. 3. How will your project address diversity, equity and inclusion? Consider incorporating this lens into project planning, marketing, and execution. How have you engaged neighborhood residents in the planning of this project. Have any special efforts been made to reach those typically not engaged in neighborhood projects? (100 word maximum)*
39. 4. Statement of Impact. For example, describe changes in the neighborhood that will result in this project. What are expected results. What is the impact of the project? Discuss who will benefit from the proposed project and how they will benefit. *
43. 9. Budget: Show evidence of careful financial planning by completing the following proposed project budget.
    Only list expenses associated with your proposed project. List both request grant funds and other cash or in-kind resources. Each field must have a numerical value. You may enter '0' as a value.
45. How much total money are you requesting? Maximum grant award is $3,000*
47. Supplies & Materials
49. Grant Funds Requested*
50. Cash or in-kind resources*
51. Total Supplies/Materials Costs*
53. Marketing/printing
55. Grant Funds Requested *
56. Cash or in-kind resources*
57. Total Marketing Costs*
59. Personnel
61. Grant Funds Requested*
62. Cash or in-kind resources *
63. Total Personnel Costs*
65. Contractors
67. Grant Funds Requested*
68. Cash or in-kind resources*
69. Total Contractor Costs*
71. Other Expenses
73. Grant Funds Requested
    Explain in text box below
74. Cash or in-kind resources
75. Total Other Costs
77. Other Expenses DESCRIPTION
79. TOTAL PROJECT EXPENSES
81. Total Grant Funds Requested*
82. Total other cash or in-kind resources*
83. Total Project Costs*
85. 10. Other resources: What community assets will you contribute or use for this project? Please provide a description of the match you noted above. Examples could include financial match, individual volunteer hours, organization or association involvement, connection to a traditionally unengaged or marginalized population, donation of equipment or space, or collaboration with another event or initiative happening in the community. (150 word maximum)*
87. Please read and acknowledge assurances before proceeding.
    Assurances
88. I hereby certify that, to the best of my knowledge, all of the information contained in the application is true and correct. *

    1. I agree
90. Thank you for completing this grant application. Once you submit this form, you will receive a confirmation email. The Community Development Advisory Commission will review applications at their next regularly-scheduled meeting. You are encouraged to attend that meeting to present your project and answer any questions commissioners may have. Contact Director of the Office of Shared Prosperity Anderson Sainci at 563-589-4110 or Asainci@cityofdubuque.org with any questions.
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92. 1. Receive an email copy of this form.
93. Email address

    This field is not part of the form submission.

94. Submit Submit and Print

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