2019 AmeriCorps State Extended Formula Funding Opportunity Notice of Intent to Apply Question Title * 1. Contact Person Name Title Address City State ZIP/Postal Code Email Address Phone Number Question Title * 2. Legal Applicant Information Organization Name Address City State ZIP/Postal Code Question Title * 3. Select the type that best describes your organization: Intermediary Nonprofit National Direct Government/Public Agency Faith-Based School District/Office of Education Other (please specify) Question Title * 4. Select the appropriate applicant type: New (has not received AmeriCorps funding within the past five years) Recompeting (applicants in their third year of a three-year grant cycle) Previously Funded (within the past five years) Question Title * 5. Select the focus areas your application will cover: Education Environmental Stewardship Healthy Futures Veterans & Military Families Economic Opportunity Disaster Services Capacity Building Question Title * 6. Select the type of grant for which you intend to apply (see RFA for definitions): Cost-Reimbursement Full-Time Fixed Amount Education Award Program (EAP) Professional Corps No-Cost Slots Question Title * 7. Select the priority area(s) your program will address: Unmet needs in the bottom five California neighborhood clusters with the lowest American Human Development Index for California:1. Tulare County: Visalia, Tulare, Porterville2. Kern County: Bakersfield3. Los Angeles County: Huntington Park, Florence-Graham and Walnut Park4. Los Angeles County: Southeast/East Vermont5. Los Angeles County: South Central/Watts Unmet needs in one or more of the following counties that currently have no AmeriCorps state members serving. Complete the table if members will serve in the following counties: Amador, Kings, Lassen, Merced, Modoc, Mono, Sierra, or Sutter. Economic Opportunity – increasing economic opportunities for communities by engaging opportunity youth to prepare them for the workforce. Education – selection of one of the evidence-based interventions in three categories: School Readiness (three evidence-based interventions), K-12 Success (nine evidence-based interventions), and Post-Secondary Support (one evidence-based intervention). In order to qualify for this priority, the applicant must be assessed as having Moderate or Strong evidence by the reviewers. Healthy Futures – reducing and/or preventing prescription drug and opioid abuse. Veterans and Military Families – positively impacting the quality of life of veterans and improving military family strength. Rural intermediaries – organizations that demonstrate measureable impact and primarily serve rural communities with limited resources and organizational infrastructure. Safer Communities – programs that focus on public safety, and/or partnerships between law enforcement and the community. Faith-based organizations. Other unmet need(s) Done