Please submit one application per program site:

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* 1. Contact and program information:

Please provide the proposed start date for the PAC program
Note: Initial application review date will be 2 weeks after the due the date

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* 2. 2021 - 2022 School Year
*Quarter 3 - Due by November 8, 2021

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* 3. 2022 - 2023 School Year
*Quarter 1 - Due by March 1, 2022

Please provide the following:
Please refer to the full program guidelines.

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* 4. Facilities Available:
Specify each room PAC will have DAILY access to and include the number of children it can accommodate.

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* 5. There are NO room rental fees associated with any rooms specified above.

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* 6. There are NO maintenance fees associated with any rooms specified above.

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* 7. There are NO utilities fees associated with any rooms specified above.

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* 8. Will keys be made available for PAC staff for all rooms specified above?

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* 9. Do all rooms specified above meet ADA accessibility standards for staff and participants?

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* 10. Is there at least one landline phone available for program staff?

Other Programs:

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* 11. Is there any other similar program(s) serving the proposed location?

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* 12. If yes, which organization(s)?

Miscellaneous:

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* 13. Will the school provide a daily healthy snack to participants?

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* 14. Will the school provide a place for program fliers/information in the office?

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* 15. Will the school provide a place for a bulletin board in the main program are?

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* 16. Are school staff interested in partnering with the PAC program for grants?

Maintenance:

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* 17. Will the school provide access to a maintenance person throughout the program hours?

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* 18. Will the school provide PAC staff access to maintenance supplies for minor clean-ups?

IGA/MOU Acknowledgement:

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* 19. I understand that an IGA/MOU must be finalized in order to place a PAC program in the above listed school district:

Thank you for completing the ARPA Phoenix Afterschool Center (PAC) Program Expansion Application!

Applications must be received by the due dates listed above and in the grant guidelines.

If you have questions, please email: pks.arpa@phoenix.gov

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