Phase I: Pre-Proposal Summary Outline Please complete the preliminary grant proposal summary form. If it is determined that your project summary falls within CMAF guidelines, you will be contacted and invited to continue the application process. You will also be invited to meet with CMAF staff for technical assistance prior to the full application deadline. The submission of this form does not constitute a grant application. Organization Information organization name tax identification number address line 1 address line 2 city state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming zip telephone fax web address organizational operating budget for current fiscal year most recent year of organization's audited financials frequency of board meetings Project Contact Information Organizational Leader Information contact name leader name contact title leader title contact email A confirmation email will be sent to this address. leader email Project Information project title request amount total project budget other identified funding sources project start date project end date History and Mission of Organization What year was your organization founded? Please provide your organization's mission statement. Briefly describe your organization and its services within greater Columbus. In what counties does your organization provide services? (Check all that apply) Franklin Delaware Licking Fairfield Madison Pickaway Union Other: Please list the zip codes in which your organization provides services. Project Summary What age group does your project plan to serve? (Check all that apply) All ages Early Childhood (0-5) Elementary (6-12) Middle School (13-15) High School (16-18) Young Adults (19-25) Adults (25-54) Seniors (55 and up) Will your project serve a particular culture or ethnic group? No Yes, check all that apply African African-American Asian Caucasian Hispanic Native American Somali Other: How many people does your proposed project plan to serve? Please provide a one to three sentence summary (Purpose Statement) of your project: (Please limit your response to 1000 characters or less) In the space below, please describe the goal(s) of your proposed project. You may also attach a Word document if you wish. Be sure to include the approach and strategies you plan to utilize to help meet your goal(s) as well as an anticipated timeline for reaching your project objectives. (Please limit your response to 2-3 pages) I will type my answer in the space provided below I will attach a Word document (you will be prompted to upload your document on the next page) Why is this project important to your organization at this time? (Please limit your response to 1000 characters or less) To print and preview your proposal before it is submitted, click the continue button below. If you have chosen to attach a Word document, you may do so on the next screen.