Reducing the impact of COVID-19 on Farmworker Families

Please note: Once you start the application you must complete and submit as there is no option to "save."

Section 1: Contact Information

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* 1. General Information

Section 2: About your organization and community you serve

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* 2. Type of organization:

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* 3. Please identify the ways in which your organization interacts with farmworkers in your area (check all that apply):

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* 4. Is your organization part of a farmworker-focused coalition?

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* 5. If yes, please list and briefly describe the members

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* 6. Approximately how many farmworkers does your organization interact with on a monthly basis, on average?

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* 7. Does your organization interact with or provide services to H-2A workers?

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* 8. Does your organization interact with or provide services to workers who live in farm labor camps or employer-provided housing?

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* 9. Which months do you have the highest number of farmworkers in your area? Check all that apply.

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* 10. What languages do farmworkers you interact with speak? Check all that apply

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* 11. What types of agricultural industries are workers you interact with employed in? Check all that apply

Section 3:  Need and Farmworkers to be served

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* 12. Briefly describe what is the specific gap or need this project is expected to address? (200 words or less)

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* 13. Please identify the key barriers farmworkers have in your area to accessing the vaccine:

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* 14. Please list each city/ town, ZIP code, or county where most of your work will occur:

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* 15. Select any or all of the populations listed below that will be a primary beneficiary of your project.

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* 16. How many farmworkers will be served by your project?

Section 4:  Proposed Workplan

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* 17. Category 1: Vaccination strategies (How do you plan to provide farmworkers access to the vaccine with these funds?)

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* 18. Please state how you plan to implement the strategies above. List any relevant partners or resources here. (200 words or less)

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* 19. Briefly describe your plan for educating workers around vaccine myths and facts, the side-effects of the vaccines, and access to care if they have an allergic reaction to the vaccine. (200 words or less)

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* 20. Category 2: Prevention and Mitigation Strategies (other than vaccination). How do you plan to support COVID-19 prevention and mitigation efforts?

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* 21. What types of COVID-19 prevention education will you implement? Check all that apply.

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Please use the workplan template to complete the required workplan information.

Please use the workplan template to complete the required workplan information.
Download the template here

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* 22. Copy and fill in the table to describe project activities, objectives, partners, projected number of farmworkers reached (& family members, if applicable), and key dates. Then be sure to upload the file below.

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Section 5:  Evaluation

Applicants must commit to completing a report that will include the following based on their scope of project. The report will be due 30 days after the last activity has been completed, or by November 1st, 2021, whichever date is earliest

Report information required, where applicable:

Vaccine Information

  • Number of farmworkers educated about the COVID-19 vaccines
  • Number of farmworkers offered the vaccine
  • Number of farmworkers who received first/only dose
  • Number of farmworkers who received second dose on time (where applicable)
  • Number of farmworkers who received second dose late (where applicable)
  • Number of family members who received vaccine (where applicable)

Prevention and Mitigation Information

  • Number of workers receiving general COVID-19 education
  • Number of care packages with PPE distributed to workers and their families (where applicable)
  • Number of workers supported through housing for quarantine/ self-isolation
  • Number of workers receiving assistance for food, health care, or other wrap-around services
  • Number of workers who lost wages due to quarantine/self isolation or caring for household members in quarantine/self-isolation and the amount of support in funds each worker received
  • Number of COVID- 19 tests purchased and/or administered
  • Number of workers provided with transportation to COVID-19 testing sites
  • Other relevant outcomes ­­­­­­­

Funded organizations will be provided with a template to submit a final report due 30 days after the completion of the project that will include a brief description of project deliverables, impact, collaboration with partners, successes, challenges, and lessons learned.

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* 23. Please indicate your understanding and acceptance of this grant requirement.

Section 6:  Budget

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* 24. How much money are you applying for? (Up to $100,000. The majority of awards will be $50,000 or less)

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Please use the budget template to complete the required budget information.

Please use the budget template to complete the required budget information.
Download the budget template here

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* 25. Copy and fill in the budget template and upload the file below.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 26. Project Budget Narrative

In 100 words or less, please describe how you will spend funds listed in the “Other” category, if applicable. Due to federal budget restrictions, mini-grant funds may not be used to buy tobacco, alcohol, food or beverages. Mini-grants also cannot pay for indirect costs.

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