CAF Applicant Info Form FY19

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Online Fillable Fields for Applicant Information

Please correct the field(s) marked in red below:

Missoula County is now accepting applications for its Community Assistance Fund (CAF) for the upcoming Fiscal Year 2019 (July 1, 2018 through June 30, 2019). Deadline for submission is May 16, 2018 at 3 p.m. Download the NOFA to learn what is needed to submit an application.

The form below is the ONLINE Applicant Information Form where applicants enter information directly into website form fields and click submit. This is the ONLINE version of Section A of the application package.

Contact Nancy Rittel at 258-4933 or by email at nrittel@missoulacounty.us if you have questions.

Agency/Organization Information

1
Agency/Organization Name
 *
2
Mailing Address (Street or P.O. Box)
 *
3
Physical address
 *
4
City/Town
 *
5
State
 *
6

Zip code (5 digits)

 *
7
Agency telephone number (format xxx-xxxx)
 *
8
Website
9
Legal status of entity
 *
Legal status of entity
10
EIN (Employer Identification Number)
 *
11
Head of Agency/Organization (First and Last Name)
 *
12
Title
 *
13
Telephone number (format xxx-xxxx)
 *
14

Email address of head of agency/organization

15

Contact Person for this application (First and Last Name)

Please re-type even if the agency head is the contact person for this application.

 *
16
Contact person's title
 *
17
Contact person's telephone number (format xxx-xxxx)
 *
18
Email address of primary contact
 *

Project Information

19
Project Title
 *
20
SYNOPSIS: No more than 300 characters (with spaces) or 50 words. Describe the project or program and the beneficiaries (e.g., who are the recipients of your project/program?). Do NOT copy and paste from your Executive Summary.
 *
21
What is the Basic Need being provided? (select one)
 *
What is the Basic Need being provided? (select one)
22
Total county dollars requested from Community Assistance Fund for Fiscal Year 2019 (whole numbers only; no comma; no decimals)
 *
  1. To receive a copy of your submission, please fill out your email address below and submit.
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