DFC Grant Application 2020-2021 - Morgan County Substance Abuse Council

Grant Application for Local Drug Free Communities

Funding Period April 1, 2020 - March 31, 2021

Basic Information
Organization Name*
Project Name*
Funding Amount Requested*
Executive Director
Organization's Phone Number*
Address*
Street Address Address Line 2 City State ZIP Code
Contact Person*
Contact Person's Phone Number*
Contact Email Address*
Not for Profit/501(c)3 Organization?*
- Yes
- No
Federal ID Number
MCSAC Priority Problem Area Your Grant is Addressing, if any
Please check any or all that apply
- Select All
- Youth use of alcohol
- Adult misuse of alcohol
- Youth use of marijuana, prescription drugs, and illicit drugs
- Adult use of marijuana, prescription drugs, and illicit drugs
Other Problem Areas Your Grant is Addressing
List other areas your grant would address (if any)
Grant Category*
Please only check one
- Prevention
- Treatment
- Criminal Justice
- Multiple Categories
The project is:*
- New
- Existing
Total Cost of Project*
Enter the total cost of this specific project (Note: this amount may be different than the amount that you are asking for from MCSAC)
Number of Individuals to Be Served*
Male Female
Primary age of individuals to be served:*
Check all that apply.
- Younger Youth (Preschool/Elementary)
- Middle School Youth
- High School Youth
- Young Adults (18-25)
- Adults (26-50)
- Adults (50 and up)
It is assumed that the population to be served will be residents of Morgan County. If not, please specify:*

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Project Overview
Describe Your Proposed Project:*
From you/your agency's perspective, what will the the project accomplish (outcomes) with respect to the problem identified? (Be specific)*
How will this project collaborate with other services and/or resources to ensure a quality project and avoid duplication?*
Can your project be accomplished if only partial funding is available?*
- Yes
- No
If yes, please explain:
If this is an existing program, please list all current funding sources and funding amounts:
List all Sources and Amounts. Click the + to add multiple
Funding Source Amount
Identify any additional funding sources for the proposed grant project, including fund raising efforts:*
List all Sources and Amounts. Click the + to add multiple
Funding Source Amount

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Detailed Budget Information
Please fill out the following questions as they pertain to the specific project you are applying for. If you do not have any money budgeted for a specific category, please indicate that in each area with a $0 or n/a. **There is an area to explain each expense category after all budget lines are completed.
Personnel Costs for This Project*
MCSAC Grant Other Funding In-Kind =Total
Travel*
MCSAC Grant Other Funding In-Kind =Total
Materials*
MCSAC Grant Other Funding In-Kind =Total
Equipment*
MCSAC Grant Other Funding In-Kind =Total
Other*
MCSAC Grant Other Funding In-Kind =Total

Please make sure to describe "Other" expenses below.
TOTAL BUDGET*
Total costs of the project. (This should be the amount in each column after totaling all the expense categories above)
MCSAC Grant Other Funding In-Kind =Total
Budget Notes*
Please specify personnel costs and give details on the other expense categories from above (Personnel, Travel, Materials, Equipment, Other)

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Please Read the Following and Sign and Date
• I, the undersigned as the responsible party, do understand that I (my agency) may be contacted by Morgan County Substance Abuse Council about my application; • I understand that priority is given to county-wide programs and those programs addressing MCSAC problem priority areas; • I understand that, if awarded funds for this grant cycle, monies will not be available for use until April 1, 2021 and that project expenditures incurred before that day will not be approved for funding; • I understand that I, or my designee, will be required to attend three (3) MCSAC Board meetings per grant year. • I further understand that this original application is to be submitted electronically, hand-delivered, or postmarked no later than 4:30 p.m. on January 29, 2020 for funding consideration. No applications will be accepted after this deadline. • I further understand that reporting requirements are as follows: 1st Quarterly Report for activity April, May, and June is due by July 15, 2021 2nd Quarterly Report for activity in July, August, September is due by October 15, 2021 3rd Quarterly Report for activity in October, November, and December is due by January 15, 2022 4th and Final Quarterly Report for activity in January, February and March is due by April 15, 2022 Where applicable, applicants must turn in final invoices for reimbursement by no later than April 15, 2022. I further understand that all monies received are to be used as indicated in this application and any monies received but not used must be returned to Morgan County Substance Abuse Council, Inc.
Signature*
By typing your name in the field below you acknowledge that you have read the above information and completed this application truthfully and to the best of your knowledge.
Date

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Grant Application for Local Drug Free Communities

Step 1 of 4

Basic Information

Project Overview

Detailed Budget Information

Please Read the Following and Sign and Date

Contact

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Male	Female

Funding Source	Amount

Funding Source	Amount

MCSAC Grant	Other Funding	In-Kind	=Total