Conflicts of interest In accordance with the Minnesota Office of Grants Management Policy 08-01, the grantee will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or present the appearance of personal or organizational conflicts of interest, or personal gain. Return of funds The grantee must promptly return to the state any funds that have been determined by the state to be ineligible for reimbursement upon review of grant documentation. PROJECT INFORMATION Project Title Please select a project name that distinguishes it from broad activity areas. Identify the primary audience that will be served by the proposed project Use an X to select all that apply to your audience. primary All ages Black or African American Families 0-5 years Hispanic or Latino Immigrants/refugees 6-12 years Native Hawaiian or other Pacific Low income 13-17 years Islander Unemployed 18-25 years Urban Suburban Rural People with disabilities American Indian or Alaska Native Intergenerational groups (excluding People with limited functional families) literacy or informational skills Estimate the number of individuals who will be served How many individuals do you expect will be served by this project (include all beneficiaries, even if they are outside of the primary audience identified in question number two). Describe how you arrived at this number. Grant Specific Information: Use this space for categories specific to the grant program PRIORITY APPLICANTS 5 POINTS POSSIBLE – Eligible for Priority Points? USE THIS TO AWARD PRIORITY TO GRANTEES WHO HAVE NOT BEEN RECENT RECIPIENTS OF THIS GRANT. DELETE IF NOT USING. Yes (0 points No (5 points added) Unsure REVIEWED AND SCORED SECTION 50 POINTS – NARRATIVE Complete applications must have responses to all numbered questions in this section. Please – review the questions and instructions in the instructions document to ensure that you are responding to all elements of each question. Enter your narrative responses within each numbered question below.
Conflicts of interest In accordance with the Minnesota Office of Grants Management Policy 08-01, the grantee will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or present the appearance of personal or organizational conflicts of interest, or personal gain. Return of funds The grantee must promptly return to the state any funds that have been determined by the state to be ineligible for reimbursement upon review of grant documentation. PROJECT INFORMATION Project Title Please select a project name that distinguishes it from broad activity areas. Identify the primary audience that will be served by the proposed project Use an X to select all that apply to your primary audience. All ages 0-5 years 6-12 years 13-17 years 18-25 years American Indian or Alaska Native Black or African American Hispanic or Latino Native Hawaiian or other Pacific Islander Urban Suburban Rural Intergenerational groups (excluding families) Families Immigrants/refugees Low income Unemployed People with disabilities People with limited functional literacy or informational skills Estimate the number of individuals who will be served How many individuals do you expect will be served by this project (include all beneficiaries, even if they are outside of the primary audience identified in question number two). Describe how you arrived at this number. Grant Specific Information: Use this space for categories specific to the grant program PRIORITY APPLICANTS – 5 Eligible for Priority Points? USE THIS TO AWARD PRIORITY POINTS TO GRANTEES WHO HAVE NOT BEEN RECENT RECIPIENTS OF THIS GRANT. DELETE IF NOT USING. Yes (0 points No (5 points added) Unsure REVIEWED AND SCORED SECTION – 50 POINTS POSSIBLE NARRATIVE – Complete applications must have responses to all numbered questions in this section. Please review the questions and instructions in the instructions document to ensure that you are responding to all elements of each question. Enter your narrative responses within each numbered question below.
minigrant_application_template_tcm36-207625.docx