Application

Thank you for your interest in First 5 Nevada County. First 5 Nevada County promotes the importance of early childhood by investing in complex systems of care, empowering families, and strengthening the community.

Completed applications are due by 5pm on December 15, 2023.

Your progress on this application will be saved on the computer that you're currently using - it cannot be accessed from other computers. Please ensure that all fields are completed (including uploading the Budget Template, Budget Narrative, and Signature Pages) before hitting "Done". 

Award notices will be mailed by March 1, 2024.

If you have any questions, please contact Rosemary Gonzalez at rosemary@first5nevco.org.

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* 1. Project Title

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* 2. Primary Contact

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* 3. Type of Business/Agency (check one)

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* 4. Business Tax ID  or Individual Social Security Number

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* 5. Descriptive Title of Project

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* 6. Summary of Proposed Project:

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* 7. Number of Children you expect to serve: (annually)

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* 8. Number of Parents you expect to serve: (annually)

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* 9. Please indicate the general region your proposal will serve:

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* 10. Total Requested Amount (please be sure to attach your completed budget template):

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* 11. Please check all that apply as a major focus of your proposed program

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* 12. Please indicate which one of the following Focus Areas is the primary focus of this project:

Please keep your answers to the following questions brief. Proposals will be scored on these answers for 50 possible points.

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* 13. Please describe the unmet need that this project will address. (5 pts)

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* 14. What actions are you proposing to address this problem or need? (What is the project?) (5 pts)

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* 15. Please describe how you will capitalize on existing programs, services, agencies, collaborations, and/or infrastructure to further the impact of the dollars. For any collaboration among agencies for this project, please include exactly what parts of the project each agency will perform. Please note that the applicant agency on the first page will hold the contract and be the fiscal agent for the project. (5 pts)

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* 16. Please describe the timeline for this project (what steps will you take)? (5 pts)

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* 17. What change do you expect as a result of this project? (5 pts)

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* 18. How will you measure this change? Please list the tools you would use and how you would use them, including specifics on what degree of change you expect to be captured by the measures. (5 pts)

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* 19. Please tell us about you or your agency. What capacities, skills, abilities, qualifications, experience, and/or credentials do you have to carry out this project? (5 pts)

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* 20. Does your program use any Evidence-Based Practices (as recognized by the California Evidence-Based Clearinghouse)? If yes, please list and describe your affiliation with the Evidence-Based Practices. If no, list Not Applicable/NA. (5 pts)

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* 21. Please describe how your organization promotes the values of equity, diversity, and inclusion within your agency and with the families your serve. (5 pts)

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* 22. As these are funds for two years, please describe how you will sustain the project after these funds have been expended. (5 pts)

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* 23. Budget Narrative - Please briefly explain the proposed budget presented below; including other funding sources, in-kind costs, and any collaborations. Please clearly state exactly what First 5 Nevada County dollars would be paying for.

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* 24. Budget Spreadsheet (download from the "Funding Opportunities" page on our website)

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

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* 25. Nondiscrimination Statement of Compliance (opens in new window)

PDF, PNG, JPG, JPEG file types only.
Choose File

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