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Community Television of Santa Cruz County Youth A/V Grant Form
Community Television's mission is to foster community dialogue and individual self-expression through television, the Internet and other electronic media. Priority will be given to organizations serving the youth of Santa Cruz County and submitting proposals that further the CTV mission. All grantees must provide content that will appear on CTV channels.

We are looking for organizations that enhance academic achievement and prepare youth and young adults for employment or higher education with skills using Digital Media tools. Our grant program is supported by PEG funds provided for this purpose, collected from cable subscribers and administered by Santa Cruz County.

Application Date *
Today's Date
MM
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DD
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YYYY
Organization name *
Your answer
Contact information *
Full address, including mailing address, telephone number and website
Your answer
Federal tax-exempt number *
Tax ID
Your answer
Name, title, telephone number, and email address of contact person for this proposal
If different from above.
Your answer
Period this funding request will cover *
Purpose of this funding request, including brief description of the population and number of individuals served, and geographic area(s) that will benefit *
As applicable
Your answer
List the results you commit to achieve during the grant period. Include the programming you will upload for CTV broadcast. What is the timeline for accomplishing these results? What evidence will prove your success? *
Brief description
Your answer
Signature of executive director or other authorizing official *
Retype name
Your answer
Edit Equipment Requested *
Maker Edit Kits
Field Equipment Requested *
Maker Field Kits
Studio Equipment Requested *
Required
Describe your organization's history, mission and goals *
Brief description
Your answer
Describe current activities, recent accomplishments, and future plans. *
Brief description
Your answer
Describe your most significant collaborations and partnerships with other entities in your field or geographic area. *
Brief desciption
Your answer
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