Neighborhood Grant Program Application - Spring 2024, Round 5

You must complete this application in one sitting; there is NOT an option to save your work.

The budget and the narrative form can be completed offline and then uploaded to this application.

There are 4 parts to your application:

Applicant and project information. Complete the application and project information below.
Download the blank application narrative form here. Complete and upload it as an attachment to your application.
Review Attachment A, Project Program Grantee Certification, and Attachment C, Unallowable Costs and Project Certification. The project lead and fiscal contact must review and confirm agreement with both documents on the application form.
Project budget. Upload the project budget in the application. Click here for a blank budget form and a sample budget form.
(If applicable) Waiver Approval for second open NGP Project. Click here to access the Waiver
(optional) Additional Documentation: You may upload up to 3 documents of additional information (estimates, letters of support or partnership, etc.).

Part I. Organization Information

Organization/Association Name

Neighborhood

Project Name

Amount Requested

Are you a first time applicant?

Yes

Do you have an open grant?

Yes

If you have an open grant, do you have an approved waiver to apply for a second grant?

Yes

I do not have an open grant

Project Eligibility

Be located within Qualified Census Tracts (“QCT”) or within a ZIP Code with a COVID-19 Impact Score greater than zero. Map information can be accessed here: inrc.org/grants/eligibility/

Project Address. Please enter the complete address of your proposed project here.

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Neighborhood Zip Code

Please enter qualified zip code in which proposed project is located for COVID-19 Impact Qualification: https://www.savi.org/apps/covid-19-impact-index

Qualified Census Tract (QCT)

Please enter qualified census tract in which proposed project is located: QCT Look-Up Tool: https://www.huduser.gov/portal/sadda/sadda_qct.html?

Organization Association Primary Contact

Name

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Verify Email

Phone

Fiscal Agent Contact

All applicants must have, or have a fiscal agent that has, active IRS 501c3 status. Grants can be awarded only to organizations with IRS 501(c)(3) status. Please list the name, contact information, organization information (including IRS EIN#) below. The fiscal agent and primary contact must be two different people for oversight purposes.

Fiscal Agent Name

First Name

Last Name

Fiscal Agent Contact Information

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Fiscal Agent Email

Please enter the email address of the project's fiscal agent/contact.

Verify Email

Fiscal Agent/Contact Phone

Please enter the phone # of the fiscal agent/contact.

IRS Employee Identification Number (EIN)

Grant funds can only be awarded to organizations with 501(c)(3) status granted by the IRS. Eligible fiscal agents should have an Employer Identification Number (EIN), also known as a Federal Tax Identification Number. Please list the organization's EIN number.

Date of Attendance at Mandatory Virtual Workshop

Please select which mandatory workshop a representative of this application attended:

Tuesday, March 19th, 6:00 - 7:30 pm

Friday, April 5th 12:00 - 1:30 pm

Attendees

Please provide the name(s) of attendees at mandatory info session.

Part II-V. Application

Complete your application and upload it here. Blank application can be found here: https://inrc.org/grants/neighborhood-grant-application/narrative-and-budget-forms-to-download-and-complete/

Application

Please upload your completed application narrative.

Part VI. Proposed Budget

Grantee Certification

Please be sure you review Attachment A, Project Program Grantee Certification at https://inrc.org/wp-content/uploads/2023/03/AttachmentA.pdf, and check yes to confirm you have read and understand.

Yes

Unallowable Costs

Please be sure you review Attachment C, Unallowable Costs at https://inrc.org/grants/neighborhood-grant-application/unallowable-costs/, and check yes to confirm you have read and understand.

Yes

Provide a budget, including income and expenses for entire project.

Sample budget form and blank budget form can be found here: https://inrc.org/grants/neighborhood-grant-application/narrative-and-budget-forms-to-download-and-complete/

Additional Documentation

Please upload any additional documentation you'd like to share (estimates, letters of support or partnership, etc.)

Additional Documentation

Please upload any additional documentation you'd like to share (estimates, letters of support or partnership, etc.)

NGP- Round 5 will have a 4 week time frame to obtain permits

This means we will not be able to award projects that take longer to obtain approvals/permits. (Examples: projects that are on Indy Parks Property, AES poles, Signage, Traffic Boxes and IHPC areas)

I understand the limited projects that are eligible in Round 5.