YMI: Community Crisis Response Initiative III

Please answer all of the following questions in the text box, keep your responses clear, concise, and to three-page maximum.

Phone Number

Additional Person of Contact Email

Organization Name

501c3 ID number

Program Focus Area

Priority Community

Council District

School District

Organization Description

1. Organization mission

a. Years of operation

b. Anticipated age group to be served.

2. Describe your organization past experience delivering summer programming to youth with a special focus on mentoring, arts and culture, sports, youth empowerment, and experiential learning.

a. Organization mission

b. Relevant Partnerships

c. Delivering culturally relevant programming

Service Delivery

1. Provide an overview of the intended program with the funds and identify program focus.

2. Program model and impact:

a. Anticipated start date

b. Anticipated number of youth served.

c. Anticipated number of engagements and or service delivery hours.

d. Will the program be online, in-person, or both. (Please describe)

e. Number of staff that will support this program, please provide the titles and roles.

f. Will the program need to onboard temporary support staff for program delivery? If yes, how many? (i.e. mentors, group leaders, counselors or consultants)

g. Will the support staff receive a wage or stipend, please explain.

h. How will tutors/ mentors or support staff be vetted, onboarded and supported throughout the program?

3. Program Outcomes:

a. Identify at least three key performance indicators/program outcomes.

b. How will program success be measured?

4. Recruitment strategy:

a. Briefly describe your overall recruitment strategy, and targeted strategy for youth on the margins (neediest).

5. How will your program support and retain youth?

6. Does your organization have a plan to engage families, please describe?

7. How will the program deliver culturally relevant curriculum?

Reporting

1. Does your organization collect demographic and academic data from program participants?

Yes

a. If yes, please share the categories.

2. Please indicate if your organization would be able to provide a report of the age, gender, grade and attendance of youth served at the end of the funding period:

Funding

1. Will your organization be able to submit an invoice outlining all eligible program expenses, as required by New York City’s procurement rules for reimbursement?

All funding must be spent by October 15, 2021.

Attachments

1. Please complete the budget template that is attached.

Budget Template File Upload

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a. Please provide a copy of your organization's 501c3 verification letter.

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b. Please provide a copy of your organization’s Doing Business Data form.

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c. Please provide a copy of your organization’s certificate of liability.

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