Mecklenburg County
Community Service Grant
Fiscal Year 2015 - 2016


Instructions
 
Thank you for your interest in Mecklenburg County’s FY2016 Community Service Grant application.  The application must be completed in one sitting.  Once you begin entering information, you will not be able to save and complete the application at a later time.  After the application has been submitted, an automatic confirmation email will be sent to the valid email address of the primary contact identified in the Proposal Cover Sheet.
Please complete the first THREE tabs, then hit SUBMIT. The fourth tab includes a budget document which you should download, complete and then upload to the fourth tab.  After submitting the budget summary, upload the following supporting documents on this page, pressing the SAVE button after each document has been uploaded. This will complete your application submission.

Note: In order to be considered for CSG funding, you must upload the following six documents for your organization. The documents must be submitted as PDFs. Failure to do provide these documents will disqualify your organization from consideration for CSG funding.
If you are submitting a joint application and therefore submitting multiple documents for each requirement, please use a separate line for each document.
 
* Audited Financial Statements prepared in accordance with generally accepted accounting principles by an independent Certified Public Accountant. The Audited Financial Statements must include a balance sheet, statement of financial position or statements of assets, liabilities and owner’s equity; a statement of income or statement of revenues and expenses; a statement of cash flows; an independent auditor’s opinion; and notes to financial statements and supplement information. The year-ended date for the Audited Financial Statements must be no more than twelve (12) months prior to July 1, 2015 :
* Copy of IRS letter certifying non-profit classification:
* Workforce Representation Documentation - Documentation supporting agency's efforts to achieve and/or promote a diversified workforce. Documentation may include, but is not limited to, diversity statement, initiative and/or management plan:
* Copies of Articles of Incorporation and Bylaws (if applicable) - If previously submitted, please do not resubmit unless changes have occurred:
* Salary Disclosure (All positions):
* Confirmation of membership with a professional association (i.e. receipt or confirmation letter):
Please contact 980-314-2907 or email grants@MecklenburgCountyNC.gov with questions.

Internal Use Only
Proposal Cover SheetService SummaryPerformance SummaryBudget Summary
Service Name (or Program Name):  
Organization:   Federal ID: Number of years with 501(c)(3) status verification:    
Organization 2: Federal ID: Number of years with 501(c)(3) status verification:  
Organization 3: Federal ID: Number of years with 501(c)(3) status verification:  
TOTAL COUNTY FUNDS REQUESTED FOR FY16 (No commas or dollar signs):     Year:
Director:
Last Name:   First Name:  
Address:  
City:          State:           Zip Code:    
Phone Number:      Fax:   
Email:  
Primary Contact:
Last Name:   First Name:  
Address:  
City:          State:           Zip Code:    
Phone Number:      Fax:   
Email: