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COVID-19 Relief Grant

2. COVID-19 Relief Grant Application
   The COVID-19 Relief Grant will provide grants to nonprofit and other non-governmental civic organizations whose mission is to provide support to children who are 18 or younger and /or served by Frederick County Public Schools. Funds appropriated shall be used to promote the general welfare of children who reside in the City. Grants awards will not exceed $10,000.00 each and may be awarded to an organization only one time. Grants are contingent on funding availability.

   The COVID-19 Relief Grant will provide grants to nonprofit and other non-governmental civic organizations whose mission is to provide support to children who are 18 or younger and /or served by Frederick County Public Schools. Funds appropriated shall be used to promote the general welfare of children who reside in the City. Grants awards will not exceed $10,000.00 each and may be awarded to an organization only one time. Grants are contingent on funding availability.

4. APPLICANT ORGANIZATION
   (As registered with the Maryland Secretary of State’s Office)

   (As registered with the Maryland Secretary of State’s Office)

6. Organization

8. Organization Address

10. Website

12. Registered Agent

14. Registered Agent Address

16. Complete Contact Info:

18. Email

20. Phone Number

22. Emergency Contact Number

24. Organization’s Tax ID

26. 1. Amount requested

28. 2. Please describe the proposed use of the requested funding, goods or products intended to be purchased, services or programs to be offered, equal opportunity for participation, benefit to the residents of the City, and estimated number of City residents benefited

30. 3. Please describe other funding sources being pursued to match or supplement any potential City contribution.

32. 4. Please describe your client base and/or the recipients of the service to be provided (include geographic and demographic information as available).

34. 5. What percentage of your clients/recipients are residents of the City and how is this quantified?

36. 6. What are the goals of the program or service to be provided?

38. 7. Please describe the metrics that will be used to assess the success of this grant in helping your organization achieve its stated goal.

40. ITEMS TO BE SUBMITTED WITH APPLICATION:
    In addition to this completed, signed grant application, please attach the following items to your application packet if applicable (initial next to each indicating attachment of the document or corresponding written explanation if not available):

    In addition to this completed, signed grant application, please attach the following items to your application packet if applicable (initial next to each indicating attachment of the document or corresponding written explanation if not available):

42. Latest Annual Report

44. Most recent Financial Statement (Audited or Reviewed) and/or most recent 990 Tax Return

46. Specific Budget related to this request

48. IRS Corporate Determination letter

50. Supporting documents such as brochures, flyers, newspaper articles, sponsorship letters, etc. describing your organization’s activities

Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field