From: Thomas Berg <email@example.com>
Date: August 16, 2010 3:40:58 PM PDT
Subject: ASNC Application for Funds Form Submission (Thomas Berg )
Reply-To: Thomas Berg <firstname.lastname@example.org>
Organization: Montecito Heights Improvement Association For Latona School
Street Address: P.O. Box 42122
City, State, ZIP: Los Angeles, CA 90042-0122
Website (if any): monteciohts.org
Contact Person: Thomas Berg
Email Address: email@example.com
Contact Person's Telephone: 323-227-6244
Amount Requested ($): $971.98
Funding Need Date (mm/dd/yy): Fall 2010
Total Project Budget if applying for event or capital project ($): $1943.96
Donations received (or expected) for this project from businesses, citizens, other gov't entities ($): $971.98
Community Project Category (select one) - examples provided denote only a sampling of the types of projects available and are not a complete list:
Education – e.g. equipment for schools, after-school programs, school capital improvements (field trips not allowed). Instructions: Complete Items 1-6 below (Item 8 optional)
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.
Purchase 4 yard benches for the school yard at Latona Avenue Elementary School. The school population is over 90% Latino. A significant percentage of the students qualify for reduced or free lunch.
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).
Several of the yard benches are damaged (have holes). This creates a potential safety hazard for young children. A child's fingers and hand could get stuck in one of the numerous holes.
3. How has your organization attempted to obtain donations from local businesses, citizens, and/or govŐt 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.
We are seeking matching funds from Montecito Heights Improvement Association. Our goal is to purchase a total of 4 benches (2 from MHIA and 2 from ASNC).
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.
No permit is required. School staff will place the benches.
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/inventoried. Cannot be turned into private property or salvaged without prior approval by Dept of Neighborhood Empowerment (DONE).
The students at Latona Avenue Elementary School with benefit from the new benches. The benches will be placed in the school yard which is fenced, gated and locked.
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/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 CouncilŐs name and/or logo.
9. 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. Mrs. Murphy, the school principal will be sending a letter of thanks after the benches are received.
DECLARATION: By checking the box below the applicant named above declares that the information provided in this form is correct. Agree
This application requires the following supporting documents be provided to ASNC before approval can be obtained. EMAIL DOCUMENTS TO ASNCTREASURER@GMAIL.COM. Check all boxes that apply. Copy of estimate/invoice (actual bill req'd for payment), Letter of acknowledgement & thanks from receiving agency
Date/Time: 2010-08-16 15:40:57 PDT
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