Grant Launch Pad "*" indicates required fields Step 1 of 6 16% General InformationProject TitleRequest Submitted By First Name Last Name ExtensionSubmitter Email Project LeadersDirector/Coordinator First Name Last Name ExtensionDivisionWriter (if different)Other Grant Team MembersHas a specific grant opportunity been identified for this project? Yes No Grant Program TitleFunding AgencyAgency Status Federal State Foundation Other Proposal DeadlineTotal RequestPerformance PeriodNumber of Months/YearsPartner OrganizationsDoes the application require 501(c)(3), non-profit status? Yes No Description of Need: What specific need or problem will the project address?Target Population: Who will the project serve? How many? How will the project identify them?Project Description: What are the project's objectives and expected outcomes? Where will the project be carried out? How will you measure success?College Implications: Explain how the project relates to college goals and/or your division plan?Sustainability: List those activities expected to continue after the grant ends. How will the activities be supported? Budget**For this section, please download the Multi-Year Budget Template, fill out, and email it to Grant Development and Management department. Indirect Cost*NOTE: Indirect funds must be included if allowed and will be utilized by institution to compensate for increased workload to affected departments (i.e. Accounting, Human Resources, Purchasing, IT, etc.)What is the maximum percentage allowed by the funding agency?Matching FundsAre matching resources required? Yes No If yes, estimated funding match amountPlease indicate source College Other Other source*Please indicate which Cash In-Kind PersonnelWill there be any grant funded staff? Yes No If yes, list positions/percentages of time needed (Note: All staff hired will be paid for by the grant budget.)AdministrativeCertificatedClassifiedConsultantData Collection RequirementsWhat data will be required to develop, implement, and evaluate this project and from where will it be obtained?Will assistance from the Office of Institutional Effectiveness be required?Will you be doing an internal or external evaluation?Public Information, Marketing & Communications ImpactWill this project require support from the Public Information, Marketing & Communications Department? Yes No If yes, please describe the anticipated marketing and outreach needs:FacilitiesList the facilities and/or equipment the college will need to provide for this project.Institutionalization and Sustainability of Project ActivitiesWhat is the effect on the college and/or division if the project is continued (institutionalized) after funding (i.e. new curriculum developed, increased FTEs by X%, need funds for software maintenance, need funds for grant staff, etc.)? Please mark all that apply. FTE Curriculum Staff Changes Facilities Other (please explain)Project will not be continued after grant funding (any grant staff will be laid off) To trigger the review process, please accept the statement, sign, and save the form. The Grant Development Department will review and contact you shortly with further instructions.SIGNATURE OF SUBMITTERBy checking the box in this section of this Rio Hondo Launch Pad online document I, (1) acknowledge that I have followed the policies and procedures of the Office of Grant Development and Management to the best of my ability to complete this form, and (2) certify that the information I have provided on this form is complete and accurate to the best of my knowledge; and (3) I acknowledge that by checking the box in this section it is a representative act of my sole signature and not that of any other individual.Accept Statement I Agree Signature of SubmitterGrant Development Department Use Only* Grant Launch Pad Reviewed SIGNATURE OF DIRECTOR OF GRANT DEVELOPMENT AND MANAGEMENT: By applying my electronic signature in this section of this Rio Hondo Launch Pad online document I, Steve Gomez (1) acknowledge that I have enforced the policies and procedures of the Office of Grant Development and Management to the best of my ability to assist in completion this form with the submitter, and (2) certify that the information I have added to, edited, enhanced, or provided on this form is complete and accurate to the best of my knowledge.Section Break
