FRS Community Grant Application

Form Title

FRS Community Grant Program Application

Organization Name

Mailing Street Address

Mailing Address City

Mailing Address State

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Verginia Wisconsin Wyoming

Mailing Address Postal Code

Organization Email Address

Organization Phone Number

Point of Contacts's First Name

Point of Contact's Last Name

Point of Contact's Title

Point of Contact's Email Address

Point of Contact's Phone Number

Give a brief explanation of organization’s history, goals, and objectives.

Which category does your application fall under?

Business and Economic Development

Community Development

Education

Telecommunications Applications

Provide a one-sentence executive summary of the project.

Identify the problem to be addressed and the needs to be met by the project.

Describe the goals and overall impact of the project.

Why is your organization the best to address the challenge? Are you working with other organizations in your community to complete the project?

What is the estimated number of people your project will affect?

What is the timeline for your project? When will the project start and end

What is the end goal and how will you measure success?

Is the project sustainable? Will the project continue after year one? How?

What is needed besides funding to make your project a success? Broadband service, marketing, staff, etc...

Requested grant amount Grant amount maximum is $5,000

How much is the total project? If the project is more than $5,000, how will the project be fully funded and what percentage of the total project costs have been secured?

Provide a budget for the project, outlining what the funds will be spent on with as much detail as possible You will not be required to purchase identified materials if alternatives are identified that complete the task. List other financial contributors to the project or other financing sources or strategies that you are developing. Please upload file for this question below.

Budget Documentation From question 26

Other Supporting Documentation

Consent for storing submitted data

Yes, I give permission to store and process my data

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