Kensington Community Resilience Fund Community Grantmaking Committee Application

Thank you for your interest in serving on the Community Grantmaking Committee for the Kensington Community Resilience Fund (KCR Fund). The KCR Fund is a new fund created to help address the community impacts of the opioid crisis in the Kensington, Harrowgate, and Fairhill neighborhoods.

The KCR Fund will provide funding to local organizations, projects, and initiatives in these areas focused on building resilience, promoting wellbeing, and improving the quality of life for all who live there.

The KCR Fund uses a community-driven process that gives community members the power to decide (a) What issues and types of programs and organizations should be funded, and (b) how actual grant dollars are spent.

Our Community Grantmaking Committee (CGC) will play a critical role in this work by reviewing and evaluating applications for funding with support from our facilitation partner Bread & Roses Community Fund.

The CGC should represent the diverse fabric that makes up the Kensington/Harrowgate/Fairhill communities. Our application is intended to ensure that members reflect this diversity and are able to commit to the work required for this role. In recognition of the time commitment CGC members will give, all participants in this group will receive a stipend.

Please reference our CGC Overview and FAQ document for additional details about the role.

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* 1. Please share your contact information.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What excites you about participating in the KCR Fund Community Grantmaking Committee?

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* 3. Please share any ways you have been impacted by the opioid crisis, directly or indirectly.

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* 4. Please share any relevant skills, experiences, knowledge and/or resources that you bring to this group. (You DO NOT need prior grantmaking experience, and your informal skills and experience count as well).

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* 5. Please list any other groups or organizations that you are a part of through your work or volunteer activities, if applicable.

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* 6. Are you able to commit to 25-30 hours of work to participate in trainings and facilitation for the CGC? **About half this time would be spent working independently (at your discretion) and the rest in meetings scheduled after work hours.

Yes

Maybe

Please share any questions or concerns you have about the time commitment

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* 7. Are there any questions or concerns you have about participating in the Community Grantmaking Committee?

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* 8. How did you hear about this opportunity? Were you referred? If so, by whom?

The following questions will address your background and demographics. The information you share here will be kept confidential. It is intended to help ensure we are capturing a diverse range of perspectives within the CGC.

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* 9. Are you of Hispanic, Latino, or Spanish origin? (check any that apply)

No, not of Hispanic, Latino or Spanish origin

Yes, Dominican

Yes, Puerto Rican

Yes, Mexican, Mexican American, Chicano

Yes, other Hispanic, Latino or Spanish origin (Please specify in comments section below)

Comments

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* 10. What is your race? (check all that apply)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Other (please specify in comment field below)

Comments

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* 11. What is your age?

Under 18

18-24

25-40

41- 65

Older than 65

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* 12. (Optional) Please describe your gender identity (choose any that apply)

Agender

Cisgender Woman (Identify with sex you were born as)

Cisgender Man (Identify with sex you were born as)

Genderqueer or Gender fluid

Transgender woman

Transgender man

Questioning or unsure

I choose not to disclose

Comments

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* 13. (Optional) Please describe your sexual identity (select any that apply)

Asexual

Bisexual

Gay

Straight (heterosexual)

Lesbian

Pansexual

Queer

Questioning or unsure

Same gender loving

I choose not to disclose

An identity not listed - please share

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* 14. How long have you lived in the neighborhood?

Less than 5 years

5 - 10 years

More than 10 years

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* 15. Do you also work in the community? If yes, please share your place of employment or type of organization you work for (eg., nonprofit, school, small business) in the comments section

Yes

Comments

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* 16. Please share any additional thoughts or questions about this work.

Thank you for your interest! Please click “done” below to submit your answers.