2008 YOUTH MINI-GRANT APPLICATION
 The First Selectman's tax force on Substance abuse

Name of Applicant / Organization

Address, City, State, Zip Code

Telephone

Fax

Contact Email Address
(priority

Contact Person
Amount Requested

ALL COMPLETED APPLICATIONS MUST BE RECEIVED BY CLINTON YOUTH AND FAMILY SERVICE BUREAU, 112 GLENWOOD ROAD, CLINTON CT 06413  BY 4:00 PM ON MARCH 20, 2008.

1. Who will be involved in this project? (i.e.: youth, adults, community, faith-based or school-based participants, etc.)
2. Briefly describe the project.
A. What is the project’s goal?
B. Who will be served?
C. When will it happen?
D. How will you measure your success?

3. The connection between your proposed project, building assets and the community is essential. Please describe this connection and how your project is directly related to asset building and the community.
4. Budget: Please complete the budget form below. Fill in project expenses and an explanation that applies below.
  Dollar Amount Explanation

Example
Materials/Supplies $ Example: crafts, snacks,
paper goods, tee shirts
Postage $ Example: correspondence,
newsletters
Telephone $  
Contracted fees $ Example: speaker fees,
entertainment
Other $ Example: transportation,
movie rental
Total Expenses $  

 

We will be unable to contact you unless all information is filled in properly !!

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