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2. ORGANIZATION INFORMATION

   This form must be completed and submitted with your proposal narrative.

4. Name of individual/agency/organization completing the application:*
6. Contact person name and title:*
8. Address:*
10. City/Town:*
11. State:*
12. ZIP:*
14. Phone:*
15. E-mail Address:*
17. Amount Requested($):*
18. Minimum amount needed for project to move forward ($): *
22. PROJECT NARRATIVE

    Your proposal should address the following questions, as applicable:

24. 1. Provide a brief description of the organization, services provided and total number of employees/volunteers.*
26. 2. If your request is for funding for a program and/or event, provide details about the program(s) for which you are requesting funding. Please include specifics, objectives, a description of activities, date(s) and time(s) of events, targeted audience, location, qualification of the presenter if applicable, and any other pertinent details of the event that may help the Commission in its decision-making process.*
28. 3. If your request is for funding for the purchase of equipment or some other physical item, please include purpose, professional documentation describing the item, model number, where the item will be purchased, price, shipping charges (if applicable) and any other information pertinent to the potential purchase which may help the Commission in its decision-making process.*
30. 4. Are there additional funding sources or applications sought to help defer the cost? If so, please provide the name of the organization(s), amount of award, and contact information.*
32. 5. How will this proposal objective enhance the lives of Framingham residents with disabilities and support the mission of the Commission?*
34. 6. Who at the organization will be involved in the oversight of the grant? How will the project be executed? Provide a timeline if appropriate. If this project is ongoing, how will it be supported in the future? If equipment is requested, please explain how ongoing maintenance will be supported and who will be the responsible party tasked with its maintenance.*
36. 7. How will this event or purchase be publicized to your target audience and the general public in Framingham? How will the Framingham Disability Commission be recognized?*
38. 8. Provide a list of expenses which includes materials, fees, equipment, maintenance, transportation, consultants, if appropriate. Additional supporting documents may be requested.*
40. 9. The Commission may request an assessment of the success of the proposal, i.e. attendance, surveys, increased awareness, testimonials, audience evaluations, etc. Upon acceptance of funding, FDC will provide a feedback form and date for a funding recipient to report to the Commission, post event or purchase.*
42. 10. A W9 is required for the issuance of funds if approved.
44. 11. Use of funds appropriated must be consistent with MGL c. 30B, the Massachusetts Procurement Laws. Please acknowledge that you understand this by typing your name and title. *

46. Funds should be spent within 6-months of project funding approval provided by City Council or at the end of the next fiscal year following approval, whichever is later, unless an extended date is approved by a vote of the Commission. Any funds not used will revert back the Disability Commission funds.

50. Signature:
52. Requestor of Funds Printed Name:*
53. Date:*
    Date:

55. As part of the evaluation process, the requesting individual/agency/organization will be asked to make a presentation before the Framingham Disability Commission at a regularly scheduled meeting, to be determined by the Commission.

    The Commission reserves the right to request additional information or further clarification to aid in its decision-making process. Proposals that positively impact Framingham residents with disabilities will be given priority recommendation to the City Council.

    Funding proposals that do not benefit persons with disabilities will not receive a Commission recommendation.

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57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

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