CCSG Application Questions for Youth Residents Survey

1.What is the name of your project?(Required.)

2.Application Information:

Contact Person Name:

Mailing Address:

Address 2:

City/Town:

State/Province:

ZIP/Postal Code:

Email Address:

Phone Number:

3.If conducting this project as a group, please tell us about your group. List their information below. ALL RESIDENTS MUST LIVE IN THE NEIGHBORHOOD.

Group Member #1:

Group Member #1 Address:

Group Member #1 Phone Number:

Do you live in the neighborhood?

Group Member #2:

Group Member #2 Address:

Group Member #2 Phone Number:

Do you live in the neighborhood?

Group Member #3:

Group Member #3 Address:

Group Member #3 Phone Number:

Do you live in the neighborhood?

Group Member #4:

Group Member #4 Address:

Group Member #4 Phone Number:

Do you live in the neighborhood?

4.If conducting this project as a group, please tell us about your group. List their information below. ALL RESIDENTS MUST LIVE IN THE NEIGHBORHOOD.(Required.)

5.What neighborhood do you live in?

6.How much are your asking for your project? (The amount must be between $50 and $600).(Required.)

7.How will you spend the money? (Please share your budget).(Required.)

8.Please share your matching support.(Required.)

9.Who or what entity will the check be disbursed to if funded?(Required.)

10.Please send your video to info@ccsmallgrants.org and put your project name and neighborhood name in the subject line.(Required.)

Yes, I sent the video

I'll send later

Current Progress,

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