INITIAL REQUEST FOR 2017 CDBG FUNDING

(Additional information, including a detailed budget, will be required should City Council desire to continue exploring your request.)

Organization Name:
Contact Name:
Project Name:
Project Address:
Organization Address:
Contact E-Mail
Telephone No: / Fax NFax:
Website (if applicable):

ApproximateCDBG funding requested: $______

PROJECT DESCRIPTION: (Describe as completely as possible the recommended project)
PROJECT NEED: (Explain why the project is needed. What problems are addressed by your proposal? You may attach additional pages, if needed.)
POPULATION SERVED OR GEOGRAPHIC AREA BENEFITTED BY THE PROJECT: (Describe the characteristics of the population to be served (i.e., youth, seniors, persons with disabilities, etc.) and the geographic area to be benefited. Estimate the number of people or households that will directly benefit from this project, the number who are low/moderate income. Indicate how this number was obtained or derived)
PROJECT OBJECTIVE: (Please state the project objective that most accurately describes what this activity will accomplish. Please select only one from the following choices.
1. _____ / Suitable Living Environment / Activities that benefit communities/families/individuals by addressing issues in their living environment, including infrastructure.
2. _____ / Decent Housing / Housing activities that meet individual family or community needs; should not be used for activities where housing is an element of a larger effort
3. _____ / Economic Opportunity / Activities related to economic development, commercial revitalization, and job creation.
PROJECT OUTCOME: (Please state the proposed project performance measurement outcome that most accurately describes what will be accomplished by carrying out this activity. Please select only one from the following choices:
1. _____ / Availability/Accessibility / Activities that make services, infrastructure, housing, and shelter available and accessible. Note that accessibility does not only refer to physical barriers.
2. _____ / Affordability / Activities that provide affordability in a variety of ways. It can include creation or maintenance of affordable housing, basic infrastructure, hookups, or services such as transportation or daycare.
3. _____ / Sustainability / Activities that promote livable or viable communities and neighborhoods by providing services or by reviving slums or blighted areas.

You are welcome to attend the Public Hearing before City Council on March 9, 2017, at 5:00 p.m. to present this basic request before City Council; however, your attendance is not mandatory for consideration of your project.

This form MUST BE received by 4:00 p.m. on Thursday, March 9, 2017, to be considered for 2017 CDBG funding. Please turn in or mail to Jenifer Thornton

Department of Community Development

1011 N. Coronado Dr.

Sierra Vista, AZ 85635

Additional methods you my use to turn in include:

faxJenifer Thornton at (520) 452-7023,

If you have any questions, please call Jenifer Thornton at 520.439.2200.