From: Jeff Goodwin
<iteach@flash.net>
Date: March 10, 2011
4:26:52 PM PST
To: asnctreasurer@gmail.com
Subject: ASNC Application for Funds Form Submission (Jeff Goodwin)
Reply-To: Jeff Goodwin <iteach@flash.net>
Organization:
Monterey Hills Federation
Street Address:
4040 Via Marisol
City, State, ZIP:
Los Angeles, 90042
Website (if any):
http://www.montereyhills.org/
Contact Person:
Jeff Goodwin
Email Address:
iteach@flash.net
Contact Person's
Telephone: 323-258-6675
Amount Requested
($): $750.00
Funding Need Date
(mm/dd/yy): 03/28/11
Total Project
Budget if applying for event or capital project ($): none
Donations
received (or expected) for this project from businesses, citizens, other gov't
entities ($): none
Community Project
Category (select one) - examples provided denote only a sampling of the types
of projects available and are not a complete list:
Health - e.g.
health fair, immunization shots for the poor, poop-bag dispensers, exercise
equipment, banner for new low-cost community clinic, advertisements to promote
drug-free living. 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.
Supply of dog
waste bags for dispenser located on Via Arbolada
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).
Dramatic
reduction in dog waste on public walkways.
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.
Up till recently,
funding was informally and privately donated.
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).
In any way that ASNC deem appropriate that MHF is able to comply with.
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/inventoried. Cannot be turned into private property or salvaged
without prior approval by Dept of Neighborhood Empowerment (DONE).
The bag dispenser
is publicly accessible to the immediate community without restriction.
Bags have been refilled on a fixed timetable so as to avoid
overconsumption.
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.
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 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)
--
Date/Time:
2011-03-10 16:26:52 PST
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