Application Current Start Preview Submission Complete Organization Information Organization Name Organization Type - Select - 501c organizations Municipalities Public Sector Organizations Regional Agencies Please select your not for profit organization category. Organization Description Organization Address Address City State/Province - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Has your organization received LEAF funding in the past? Yes No If so, has the project been completed? Yes No Attach updated grant report for previous LEAF funding. Since your previous project has not been completed, an updated grant report for that project must accompany this application. Primary Contact Information Name of Applicant Email Address Phone Address Address City State - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code If different from Organization Address Project Information Name of project Project manager name Project manager email Project manager phone Project description Detail goals, community impact, needs met, and additional resources, if applicable. Please include specific details on the project the LEAF grant will be used for. Also include other organizations you will be working with. Physical address of project (if different from organization address) Address City/Town State/Province - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ZIP/Postal Code Total project cost Request for emergency funding? Yes No REQUESTS FOR EMERGENCY FUNDING: Please refer to guidelines for eligibility. Contact [email protected] with reasons for emergency need. Amount of funding requested Is this project able to be completed with partial LEAF funding? How will a reduced budget will effect your project? Do you require LEAF funding, to secure additional funding, prior to beginning the project? Yes No We encourage applicants to secure additional funding towards projects. Please list any additional funding you have secured or are actively working towards. Priority will be given to applicants that can match or provide additional funding. When will funds be required for the project? Answer as applicable - Is this project ready to implement? Is a location secured? Have contractors provided estimates? Staffing, maintenance or insurance lined up? Have all local, state, and federal requirements been approved (if so, list)? Is additonal funding in place (if so, list)? Is there a plan for long term maintenace? Who will handle this maintenance? Example Budget Template Project budget (1 page max)? One file only.64 MB limit.Allowed types: pdf jpg jpeg gif png doc docx xls csv txt numbers. Organization budget (1 page max) One file only.64 MB limit.Allowed types: pdf jpg jpeg gif png doc docx xls csv txt numbers. How will a reduced budget effect your project? Project timeline How does your project address accessibility, diversity, and inclusion as it pertains to North Elba residents and visitors? How will your project specifically enhance the community for the people that live in North Elba? How will your project enhance the North Elba visitor experience? What is the long term impact of your project? How you will measure project success and outcomes? Latest financial audit and/or 990 form (if available) Maximum 2 files.64 MB limit.Allowed types: pdf jpg jpeg gif png doc docx xls csv txt numbers. Additonal project attachments (if any) Maximum 10 files.64 MB limit.Allowed types: pdf jpg jpeg gif png doc docx xls csv txt numbers. Date Email I hereby acknowledge that I have completed this application in good faith, confidence, and counsel, and have done so in full compliance with the law. I have made no attempt to falsify or misconstrue facts or data anywhere in this application. Signature Please note: By typing your name in the signature field above, you are signing this application electronically. Leave this field blank
