Organization:
Street Address:
City, State, ZIP:
Website (if any):
Contact Person:
Email Address:
Contact Person's Telephone:
Amount Requested ($):
Funding Need Date (mm/dd/yy):
Total Project Budget if applying for event or capital project ($):
Donations received (or expected) for this project from businesses, citizens, other gov't entities ($):
Community Project Category (select one) - examples provided denote only a sampling of the types of projects available and are not a complete list:
Category name (if none of above):
1. Summary of Request: In the space below, briefly describe the purpose of the request, activities to be undertaken, target population —including ethnicity, gender, income level and estimated number of individuals — geographic focus and other relevant info regarding the request.
Example: Purchase sign for a community clinic that serves more than 1,000 low-income individuals, predominately, Latino & Asian immigrants in the Montecito Heights, Hermon & Sycamore Grove areas.
2. How will the community be impacted by the proposed project and how will it benefit the neighborhood? Rationale: Community projects must directly benefit ASNC communities. Concerns about who & how many individuals will benefit from such projects also need consideration. Issues of access and fairness need to be addressed (e.g. if a project is approved to plant trees on one street corner, justification should be provided as to why that street corner needs trees or clean-up versus other street corners).
3. How has your organization attempted to obtain donations from local businesses, citizens, and-or gov’t agencies to offset expenses for this community project?
Rationale: Community groups cannot expect all funding to be provided by ASNC but should first look for other sources, including businesses, citizens, council districts, public agencies (e.g. Cultural Affairs), and other affected neighborhood councils.
4. In what ways will the ASNC's financial support of this project be acknowledged & publicized? Examples: ASNC sponsorship mentioned in a prominent way on outreach materials, listed on the event or sponsoring group's website as a financial supporter, and listed in printed programs and display tables. (Note: The ASNC should be asked to provide appropriate text and design for advertising).
5. If this is for a capital improvement project, specify location and permits obtained (or in-process of obtaining). Provide copies of permits and insurance with application. Rationale: Capital improvement projects should be on public property, with coordination with the appropriate city agency (i.e. Street Services, Fire, Rec & Parks, etc). Appropriate permits need to be in place, and insurance may be required depending on the nature of work that will be performed.
6. If this is for program services (ie. after-school program, graffiti removal, etc), describe the selection process used to establish participants if for select group of individuals. Provide number of participants.
Rationale: If for a select group of individuals, a fair selection process should be created to establish participants. The service program needs to be provided by a legitimate non-profit consultant. A neighborhood council or its members should not provide these services.
7. If this is for equipment and supplies, describe specifically who will benefit and how it will be controlled. Rationale: Equipment and supplies for either public or private organizations can only be used for the benefit of the local community. Purchases intended for private and or paid use are not allowed. Must be labeled as ASNC-purchased material and properly controlled and inventoried. Cannot be turned into private property or salvaged without prior approval by Dept of Neighborhood Empowerment (DONE).
8. If this is for an event, describe the intended audience, location and entry requirements. Rationale: Events must be open to the public. There should not be an admission charge. If the event is on private property, insurance may be needed. If the event is on city property, appropriate permission and permits from city departments may be needed (i.e. street services, LAPD, R&P, etc)
9. If this is for a sign, banner or advertisement, describe the contents. Provide a copy of the artwork with the application. Note: Banners, signs and advertisements must include the Arroyo Seco Neighborhood Council’s name and or logo.
10. Other - please provide other important information necessary to better understand your organization or the specific needs of the targeted group or community that this request will serve.
DECLARATION: By checking the "Agree" box the applicant named above declares that the information provided in this form is correct.
This application requires the following supporting documents be provided to ASNC before approval can be obtained. EMAIL DOCUMENTS TO treasurer@asnc.us. Check all boxes that apply.
Examples of Unacceptable Purchases: