2014 Neighborhood Block Watch Grant Application

Page 1

City of Phoenix2014Neighborhood Block Watch Grant Program

Long-Form Application

Request for Funding - $10,000 Maximum

PLEASE READ the information provided in the “Welcome to the 2013 Neighborhood Block Watch Grant Program” on the website (
Application Deadline: Thursday, January2, 2014, at 4 p.m.
Return To: Police Headquarters, Fiscal Management Bureau,
620 West Washington Street, Suite 326
All primary applicants MUST be listed with the City of Phoenix’s Neighborhood Notification service by Thursday, January 2, 2014, at 4 p.m., to be eligible to receive an award.

1.PRIMARY APPLICANT – Only neighborhood organizations/ Block Watch groups can apply as Primary Applicants. HOA’s cannot apply for a grant as a primary applicant; however, the residents inside of a Home Owners Association (HOA), which are registered as a Block Watch or neighborhood organization, may apply.

Provide the exact name and organization identification number (four digit number provided upon listing) of your organization as listed with the City of Phoenix’s Neighborhood Notification service. If primary applicant is not listed by January2, 2014, APPLICATION WILL BE DISQUALIFIED.

Please select your organization type by marking the box below.

1a. Is your organization listed with the City of Phoenix’s Neighborhood Notification service?

Yes No

1b. Primary applicants MUST submit copies from four neighborhood meetings from separate months during the previous calendar year that contain a crime suppression topic. Grant applications become public records; required attachments (meeting agendas/minutes) MUST not include personal information (e.g., phone number, name, mailing address,e-mail address, etc.). The number of individuals in attendance MUST be indicated on each agenda/minutes, however.

1c. Optional grant application attachments are limited to five pages.

1d. If requesting grant funds for a newsletter or website, as sample of the newsletter or link to the website MUST be provided with the grant application.

1e. Are you partnering with another organization on this application? Yes No If No, skip to question 3.

2.CO-APPLICANT – Must apply with a Primary Applicant, as defined above.

Please select the type of organization your co-applicant group is by marking the box below.

Name of your organization: (If a non-profit organization, name as listed with the Internal Revenue Service)

3.What is the title of your project? EXAMPLE: The Neighborhood Graffiti-Free Project

4. List the name, address, phone number(s), and e-mail address of the person who will receive all mailings and correspondence regarding this application: Please notify grant staff if any information listed below changes.

LastName: First Name:

Street: City: ZIP:

(P.O. Boxes will not be accepted.)

Phones: Work: Home: Cell: E-mail:

5 List the geographic boundaries, including Council District(s) and Police Precinct(s), which will be directly impacted by your grant project. EXAMPLE: North: Camelback Road; South: Campbell Avenue; East: 16th Street; West: 12thStreet, or if your project is citywide check the ALL box for Council Districts. Council District 6, Central City Precinct

North: South:

East: West:

Please list the approximate number of households served by your Block Watch/neighborhood organization:

Council District(s): 1 2 3 4 5 6 7 8 ALL Police Precinct(s):

6.Which of the following will your project impact?

Detect, Deter, and Delay Crime

Improve the Quality of Life Within Neighborhoods by Preventing Crime
Encourage Citizens to Have Pride in Their Neighborhood by Preventing Crime

Motivate Citizens Toward Common Neighborhood Crime Prevention Goals

Coordinate Pertinent Crime Prevention Neighborhood/Community Meetings
Teach Crime Prevention and Safety Techniques

7.Briefly describe your organization – when and why it was formed and your overall crime prevention goals. List the current services your organization provides.

Date your organization was formed: Month - Year -

8.In the space below, summarize your grant project in 150 words or less. Your summary should include what you plan to achieve, goals or objectives, and how your project will reduce crime and educate citizens on safety or crime prevention techniques. Please describe the anticipated donated and volunteered participation for your grant project. (Paid positions are not to be considered as volunteer hours. Volunteers cannot be paid with grant funds.) Involvement by a Block Watch group is highly recommended. If your project includes field trips, they must contain a crime prevention component and include the volunteer hours. If no narrative is provided, a budget item may be vetoed.

Example: Our project is for our neighborhood to be graffiti-free having the color of our fences; bridges, etc., consistent original colors. Covering graffiti as soon as possible sends a clear message to gangs that they are not welcome. Although Phoenix's Graffiti Busters Program will paint over graffiti free, it is often untimely and paint color is not an option. Repainting in the original paint color shows gangs and residents alike that we have pride in our neighborhood and are attempting to protect it. The deliverables will be measured by attendance and discussions at our Block Watch meetings and various safety classes held throughout the year by our Community Action Officer, and Station No. 1234 firefighters.

9.Provide information or examples of any past projects or experiences regarding crime prevention, safety enhancements, neighborhood enhancements, or improvement efforts in which your organization or individuals within your organizationsuccessfully and consistently participated. Include the number of hours your group’s volunteers have contributed during the past grant year and in what capacity. If you have received a Neighborhood Block Watch Grant in the past, please indicate year and amount below.

Year(s) Previously Funded: Funded Amount(s):

  1. Total amount of grant funds requested:

Please make sure the dollar amount you enter here in #10 is correct. This dollar amount should be the same amount as listed on Page 5, Question 12, of the Grant Budget request. Use caution not to request prohibited items, which are listed on the next page.

11. Authorized Signatures:

The name, home (for individuals) or business (for companies) address, e-mail address, and home and alternate phone numbers of two representatives who will sign the NBW Grant contract and be responsible for fulfilling all grant requirements, including quarterly, financial, and program reports, for the term of the contract must be indicated below. If this is a collaborative/joint application, a representative from each organization must be indicated and must sign the Grant contract and be responsible for fulfilling all grant requirements.

Members of the Neighborhood Block Watch Grant Program Oversight Committee CANNOT BE SIGNERS on NBW Grant applications.

Individuals who reside or work at the same physical address or who are related (including by marriage) CANNOT SIGN THE SAME NBW GRANT APPLICATION.

The below-listed individuals hereby offer and agree to perform in compliance with all terms, conditions, specifications, scopes, and project descriptions in the application and grant contract. Applicants certify that all information in this application is true and accurate to the best of their knowledge. Applicants understand that the City of Phoenix may approve grant awards with modification to scope items, methodology, schedules, final products, and / or budgets.

Signatures are not required for electronically submitted applications, but please list all other information.

Name /
Signature
/
Organization/Title
/
Address
/ Phone Other/Home
E-mail
Phone Phones Phones
1. / O:
H:
E-mail:
2. / O:
H:
E-mail:
3. / O:
H:
E-mail:

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