A P P L I C A T I O N I N F O R M A T I O N
All applicants must be ready to submit the following via Google Form. Please note no emailed applications will be allowed:
• Organizational information and website
• Organization Contact
• Funding Request (Amount requested)
• Funding Proposal (Please provide detailed description on how award funding would be utilized by your organization)
• Program Impact (Please highlight gaps filled, services provided or other activities award funds will provide to Adams County.)
• Budget (Upload budget PDF or Spreadsheet. Please one form only)
• Funding Impacts to Adams County Community (Checklist, mark all that apply)
• Program Scope (Checklist, mark all that apply)
• Certificate of Good Standing (IRS) (One File only PDF, Document, or Image)
• W-9 Tax Form (One File only PDF, Document, or Image)
• Audit Results (If applicable only)
• Letter of Partnership and Support (PDF only. One file only please.)
• Anticipated fund expenditure (Provide date when funds will be expended.)
• Organizational information and website
• Organization Contact
• Funding Request (Amount requested)
• Funding Proposal (Please provide detailed description on how award funding would be utilized by your organization)
• Program Impact (Please highlight gaps filled, services provided or other activities award funds will provide to Adams County.)
• Budget (Upload budget PDF or Spreadsheet. Please one form only)
• Funding Impacts to Adams County Community (Checklist, mark all that apply)
• Program Scope (Checklist, mark all that apply)
• Certificate of Good Standing (IRS) (One File only PDF, Document, or Image)
• W-9 Tax Form (One File only PDF, Document, or Image)
• Audit Results (If applicable only)
• Letter of Partnership and Support (PDF only. One file only please.)
• Anticipated fund expenditure (Provide date when funds will be expended.)
M O N T H L Y R E P O R T I N G I N F O R M A T I O N
All applicants must be ready to submit the following monthly report via Google Form. Reports are due by the 5th of every month. Please note no emailed applications will be allowed:
• Organization Name
• Person filling out report, email, and phone.
• Today’s Date
• Report time frame (Should reflect months activity. (See example)
• Fund Expenditure Summary (Click here for example)
• Impact Report (Click here for example)
• Remaining Fund Balance
• Share a success story
• Organization Name
• Person filling out report, email, and phone.
• Today’s Date
• Report time frame (Should reflect months activity. (See example)
• Fund Expenditure Summary (Click here for example)
• Impact Report (Click here for example)
• Remaining Fund Balance
• Share a success story