Community Improvement Grant Application Survey

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Thank you for your interest in the Community Improvement Grant Program. Redwood City wants to help jump-start your neighborhood and community improvement projects and events, and encourage you to get together with your neighbors to plan and implement a great community-building activity!

There are two levels of grants:

1. A grant of up to $100 - for a neighborhood gathering (for example a block/neighborhood party or a pot-luck dinner). To apply for the grant of up to $100, fill out questions #1 through #14, then skip to #22 and #23.

2. A grant of up to $300 - for a more ambitious large neighborhood event (for example a community garden, community clean-up project, large multi-street block party, a neighborhood newsletter or website, etc.). Preference is given to new projects. If yours is an existing (repeated) project, you must show how you will use this grant to expand or broaden its scope, outreach, public involvement, and community benefit. To apply for the grant of up to $300, fill in questions #1 through #23.

Instructions:

• Fill out the application form (items with an asterisk are required).

• Call the Redwood City Fire Department at 780-7400 and schedule their attendance for a portion of the event to provide emergency preparedness information, if your project is an event or gathering.
(NOTE: Neighborhood Watch meetings that a police officer attends do not require fire department attendance

• Provide an estimate of expenses, or final costs if the event has already taken place; you'll be asked to send us copies of receipts when we send you the check, and once your project is complete.

• If there are funds left over from this grant, you are requested to return them to the city.

1.	Name:*

2.	Daytime phone number:*

3.	Evening phone number:*

4.	Email:*

5.	Address:*

6.	Name of event/activity:*

7.	Date of event/activity:*

8.	Address/location of event/activity:*

9.	How did you hear about this grant?*

10.

Expense Item Description for event/activity that is scheduled (if your event has already taken place, please skip to #11):
On each line, enter a description of the item, and the estimated expense. NOTE: You'll be asked to send us copies of receipts when we send you the check and once your project is complete

Expense item description & estimate
Expense item description & estimate
Expense item description & estimate
Expense item description & estimate
Expense item description & estimate

11.

Expense Item Description for events that have recently taken place (if the event/activity has not yet occurred, fill in #10 only):
Enter a description of the item, and the final cost for each. NOTE: You'll be asked to send us copies of receipts when we send you the check

Expense item description & final cost
Expense item description & final cost
Expense item description & final cost
Expense item description & final cost
Expense item description & final cost

12.	Amount of your grant request:* (Maximum of $100/$300 - amount of approved grant may differ)

13.

What is the approximate time that you have requested the Redwood City Fire Department attend this event/activity and provide emergency preparedness information:*

Please note that the Fire Department personnel may need to respond to an emergency call before or during their attendance at your activity. If this occurs, they will make every effort to return before the end of your event. If they cannot return that day, it is your responsibility, as part of accepting this grant, to contact the fire department and schedule another suitable date and time for them to provide general information on emergency preparedness – that date could be any other scheduled neighborhood gathering or a gathering specifically to receive emergency preparedness information.

Important:

- If you are applying for a grant of up to $100 please skip ahead to question #22 to check the signature box, and #23 to enter today's date.

- If you are applying for a grant of more than $100, for a “more ambitious large" project as described above, please continue with questions, #14 through #23.

14.	Is this a new event/activity?
	Yes No

15.	If this is an event/activity that has been implemented before, how will you use this grant to expand or broaden its scope, outreach, public involvement, and community benefit?

16.	Has your neighborhood received one of these grants before?
	Yes No

17.	If you answered yes above, when and how much was the previous grant?

18.	Please describe and list the dollar amount of other funds, if any, that are being provided toward this project/event:

19.	Number of households expected to attend:

20.

Names/addresses of individuals working on this project with you (a minimum of three different households is required):

name/address
name/address
name/address

21.	Describe the positive effect this project or event will have on the neighborhood/community:

22.	Check this box to indicate your electronic signature*
	This indicates my electronic signature

23.	Please enter today's date*

If you'd like to print a copy of your grant application, click on the print button below. Otherwise, please click on the "Done" button to have it automatically emailed to our office.