Cleveland Climate Action Fund

2015 Micro Grant Program

Guidelines and Application Form

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The Cleveland Climate Action Fund fosters opportunities for individuals and organizations to take an active part in mitigating climate change through climate resiliency and adaptation as well as community empowerment.

Objectives
● Engage Clevelandneighborhoods to take climate action in order to reduce carbon pollution and to improve quality of life

● Help Cleveland neighbors work together in order to meet community needs

● Encourage participation of people from all walks of life

● Help build the capacity of neighborhoods to participate in climate action

● Encourage partnerships and collaboration in Cleveland because we can do more if we work together.

Eligibility

Applications must be received by the established deadline to be considered for funding.

Applicants must apply to fund projects that are located in Cleveland neighborhoods and whose focus is reducing carbon and / or creating healthier communities and /or building social / economic strength.

Applications can be made requesting an amount not to exceed $5000 in support of individual projects. Individuals, community groups, schools, organizations, businesses and stakeholders submitting an application must have an established fiscal agent (501c3 IRS designation) to be considered eligible for funding

Application Submission Methods

Applicants must complete EACH question or section of this grant application form and submit via ONE method:

  1. Electronically via
  2. Scanned version emailed to
  3. Typed / hand written hardcopy sent to:

Cleveland Carbon Action Fund
℅ Cleveland Museum of Natural History
1 Wade Oval Drive
Cleveland, OH 44106

Receipt of all application submissions will be acknowledged via email.

Additional pages may be attached as needed.

Evaluation Criteria

Cleveland Climate Action Fund will assess your project proposal based on several key factors: alignment with our mission of carbon reduction or improving community health / wellness, ability / stability / willingness of the project team involved, degree and likelihood of achieving measurable goals,

The applicant : What is the applicant’s motivation and commitment to the project? Does the applicant/ group have the skills and experience to implement the proposal?

The project : Is the project addressing a real need / concern of the neighborhood? Will the project reduce carbon, have social or economic impact, and / or promote health wellness in the neighborhood? Is the project outcome able to measured and verified? Does the project have clearly defined goals?

The context : Does the applicant have strong partnerships and support in the neighborhood? Is the applicant connected to the target community? Will the project empower the applicant

The sustainability model: Is there a potential for scale and sustainability? Is there a market or a clear dissemination model?

The workplan and budget: Is the timeline to complete the project is realistic? Is the budget to complete the project thorough and feasible? Is there a clear implementation strategy?

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Applicant Information

Project Name: ______

Date of Application: ______

Type of Applicant - select and circle one

IndividualBlock Club / Resident Group
School GroupFaith-based Group
Youth GroupMerchant / Area Business
Civic AssociationSafety Group

Health / Wellness GroupOther ______

Does the applicant or organization qualify as a non-profit with full 501(c)3 designation status

(tax exempt charitable organization according to the IRS) ?YESNO

If yes, then provide EIN number ______

If not, then please identify which non-profit with full 501(c)3 designation status will be serving as the fiscal agent of this project:

Name______
Address______
Phone______
EIN Number ______
Attach letter on fiscal agent letterhead confirming the fiscal agent relationship established

Name of primary contact person for this application:

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Contact mailing address: ______

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Contact phone number:______

Contact email address:______

Total number of people involved /supporting this project______

Provide two - five additional KEY people and their role to faciliate success with this project : ______

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Tell us about yourself / your group? How long established? What is your overall mission? Demographics of people in the group? What are some of your accomplishments?

(maximum word count 300)

Project Details

Have you previously applied for a CCAF grant?YESNO

If so, when and what was the project name?______

Name the Cleveland neighborhood that your project will predominantly serve ______

What is the focus of your project: (circle all that apply)

  1. Carbon reduction
  2. Community health / wellness
  3. Community economic development

How many people will your project serve / impact ______

What is the estimated total cost of your project ______

How much funding are you requesting from CCAF: ______

Exact / approximate address of your project ______

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Describe your project in detail: What do you plan to do? What need will your project solve? How will your project reduce carbon or improve health / wellness? How will your project serve your neighborhood? What resources will you use to complete your project?

(500 maximum word count)

Describe in order the main activities / steps to be taken to execute your project, the timeframe associated with each step, and the responsible person(s) associated with each step

Tasks in Order / Start & End Date / Responsible for Task

Estimated start date of your project?______

Estimated completion date of your project? ______

How will your project’s impact / effectiveness be measured?

(200 word count maximum)

What is the long-term goal for your project?

(200 word count maximum)

How will your project become sustainable or commercially viable in the future?

(200 word count maximum)

Project Budget
What is the estimated total budget of your project?______
What amount of funding does your project currently have? ______

What is the source of your current funding? ______
Are you applying for / generating funding for your project elsewhere?YESNO

If yes, then explain the source of those potential funding streams?

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Do you anticipate your project receiving in-kind donations? YESNO

If yes, then explain the source of those potential donations?
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Itemize your budget. Identify all the costs that are necessary and reasonable to complete the work described in your proposal. Round amounts to whole dollars.

Budget Expenses / Amount / Justification
Personnel / Stipend / Salary
Venue / Space
Supplies / Materials
Training / Education
Equipment
Contract Services
Permit / Fees
Marketing / Communication
Admin / Legal / Accounting
Other
Other
Other

Supplementary Documentation

Help us assess your application by including any supplementary material that support your project.
These are not required, but may be helpful for the review committee

· Sketches, pictures, renderings, video links

· Resumes of key project participants demonstrating their skill set

· Articles, blogs, examples of comparable projects

· Recommendation letters from any community partners

· Anything else you would like to share with us that strengthens your application

Cleveland Climate Action Fund

Grant Application Checklist

  • Confirmed eligibility criteria met
  • Completed every section of grant application
  • Provided letter confirming fiscal agent relationship
  • Included any supplementary documentation
  • Sent (postmarked) or transmitted by the deadline date