Cash Match In-Kind Requested (Total Cash TOTAL (Total In-Kind/% Funds Match/% of Total FUNDS of Total Funds) Funds) $ $ A. Board Support (limited to $ $ % 10% of the total competitive % request) $ $ B. Competitive Program Title: $ $ % % $ $ C. Competitive Program Title: $ $ % % $ $ D. Competitive Program Title: $ $ % % $ $ Competitive Total $ $ % % Check All That Apply: Requesting Competitive Funding Requesting Competitive Disconnected/Opportunity for a Program/Strategy Funding for Planning Youth Requesting Competitive Funding Requesting Competitive Parental Incarceration for a Program/Strategy Funding for Planning Requesting Competitive Funding Requesting Competitive Youth Homelessness for a Program/Strategy Funding for Planning Requesting Competitive Funding Requesting Competitive Childhood Hunger for a Program/Strategy Funding for Planning Multi-Jurisdictional Plan for (list title): Check if Lead Board Participating Boards (list below) Requesting Extra Points for: Two Generation Approach Race Equity 25% Cash Match Name, title, telephone and email of staff point of contact: Board’s Name, title telephone, and email of project contact (if different from above): Board’s Name, title telephone, and email of fiscal contact (if different from above): Board’s By signing below, I hereby certify that the Local Management Board reviewed and approved this application, and complied with the local conflict of interest and ethics policies in the development of the application.
Requested Funds Cash Match (Total Cash Match/% of Total Funds) In-Kind (Total In-Kind/% of Total Funds) TOTAL FUNDS A. Board Support (limited to 10% of the total competitive request) $ $ % $ % $ B. Competitive Program Title: $ $ % $ % $ C. Competitive Program Title: $ $ % $ % $ D. Competitive Program Title: $ $ % $ % $ Competitive Total $ $ % $ % $ Check All That Apply: Disconnected/Opportunity Youth Requesting Competitive Funding for a Program/Strategy Requesting Competitive Funding for Planning Parental Incarceration Requesting Competitive Funding for a Program/Strategy Requesting Competitive Funding for Planning Youth Homelessness Requesting Competitive Funding for a Program/Strategy Requesting Competitive Funding for Planning Childhood Hunger Requesting Competitive Funding for a Program/Strategy Requesting Competitive Funding for Planning Multi-Jurisdictional Plan for (list title): Check if Lead Board Participating Boards (list below) Requesting Extra Points for: Two Generation Approach Race Equity 25% Cash Match Name, title, telephone and email of Board’s staff point of contact: Name, title telephone, and email of Board’s project contact (if different from above): Name, title telephone, and email of Board’s fiscal contact (if different from above): By signing below, I hereby certify that the Local Management Board reviewed and approved this application, and complied with the local conflict of interest and ethics policies in the development of the application.