Organization Name Street Address City, State, and Zip Federal Employer ID Number (FEIN/EIN) DUNS Number Institution of higher education Local government / school district Type of Organization: State agency Nonprofit organization (501c3) CONTACT INFORMATION Primary Program Contact (Name & Title) Phone Number Email Address Concept Completed By (if different) Number Email Address APPLICATION INFORMATION New (First-time or Previous Sub-grantee) Concept Paper Type Current Sub-grantee with new project Cost Reimbursement/Traditional Formula Grant Type Cost Reimbursement/Professional Corps Education Award Only Program Disaster Services Economic Opportunity Area(s) of the Proposed Program Education Environmental Stewardship (check all that apply) Healthy Futures Veteran & Military Families Proposed AmeriCorps Program Name Proposed Program Period – The program period may not start prior to August 1, 2017 and may not be longer than a 12-month period. MEMBER SLOT ALLOCATION Full- Half- Reduced Quarter- Minimum- MEMBER SLOT TYPE Time Time Half-Time Time Time (1.00 MSY = 1 Full-time Member) (1.00) (0.50) (0.26455) (0.21164) Minimum number of hours required 1700 900 675 450 300 Enter the proposed number of Member slots *All applicants must request a minimum of 5.00 MSY.* GENERAL INFORMATION Does your organization have: Prior experience administering AmeriCorps grants? Yes No experience administering other federal grants? Yes No Any delinquent federal debt? Yes No (If yes, you are ineligible to apply until debt is resolved.) Please respond to the following clearly and concisely.
Organization Name Street Address City, State, and Zip Federal Employer ID Number (FEIN/EIN) DUNS Number Type of Organization: Institution of higher education Local government / school district State agency Nonprofit organization (501c3) CONTACT INFORMATION Primary Program Contact (Name & Title) Phone Number Email Address Concept Completed By (if different) Number Email Address APPLICATION INFORMATION Concept Paper Type New (First-time or Previous Sub-grantee) Current Sub-grantee with new project Formula Grant Type Cost Reimbursement/Traditional Cost Reimbursement/Professional Corps Education Award Only Program Area(s) of the Proposed Program (check all that apply) Disaster Services Economic Opportunity Education Environmental Stewardship Healthy Futures Veteran & Military Families Proposed AmeriCorps Program Name Proposed Program Period The program period may not start prior to August 1, 2017 and may not be longer than a 12-month period. – MEMBER SLOT ALLOCATION MEMBER SLOT TYPE (1.00 MSY = 1 Full-time Member) Full- Time (1.00) Half- Time (0.50) Reduced Half-Time Quarter- Time (0.26455) Minimum- Time (0.21164) Minimum number of hours required 1700 900 675 450 300 Enter the proposed number of Member slots *All applicants must request a minimum of 5.00 MSY.* GENERAL INFORMATION Does your organization have: Prior experience administering AmeriCorps grants? Yes No experience administering other federal grants? Yes No Any delinquent federal debt? Yes No (If yes, you are ineligible to apply until debt is resolved.) Please respond to the following clearly and concisely.
2017-Concept-Paper-Template.docx