Coronavirus (COVID-19) Relief & Recovery Application
Email address *
***SECTION 1: WELCOME***
The following funders in Palm Beach County have joined together to establish a coordinated Coronavirus (COVID-19) Relief & Recovery application process:

• Allegany Franciscan Ministries
• Children’s Services Council of Palm Beach County
• Community Foundation for Palm Beach and Martin Counties
• Jewish Federation of Palm Beach County
• Lost Tree Foundation
• Mary and Robert Pew Public Education Fund
• Quantum Foundation
• United Way of Palm Beach County

Funding Priorities include:
• Emergency food, shelter and other basic needs
• Expansion of service capacity related to increased demand for direct services
• Access to health care services for uninsured and underinsured clients
• Technology and other resources to allow your organization to continue to provide services
• Reimbursement of lost revenue

Because we may receive a high volume of requests for these funds, applicants are advised that we do not expect to be able to cover all funding requests; and we may not be able to fund the full amount of each request. However, we are committed to make the best use of available resources to address the highest priority needs. To address these concerns, applicants are limited to nonprofit organizations providing services to Palm Beach and/or Martin County residents.

Nonprofit organizations are encouraged to submit applications as soon as possible. Applications will be reviewed as they are received, and awards will be made periodically. Currently there is no application deadline.

Funding will be made directly from the participating funder to the applicant agency. Final funding decisions and reporting requirements are exclusively the purview of the participating funder.

DO NOT separate your request into 2 applications. Each organization is only allowed to submit 1 APPLICATION.

***Questions?***

Please contact one of the following:

Randy Palo, Director of Program, Children's Service Council of Palm Beach County
randy.palo@cscpbc.org, 561-374-7595

Alexandra Boyle, Community Impact Assistant, Community Foundation for Palm Beach and Martin Counties
aboyle@cfpbmc.org, 561-340-4513
***SECTION 2: APPLICANT INFORMATION***
Organization Name *
Your answer
Tax ID Number *
Your answer
Administrative Office Address *
Your answer
Contact Person *
Your answer
Phone Number *
Your answer
Briefly describe the mission of your organization *
Your answer
***SECTION 3: PROPOSED USE OF FUNDS***
DO NOT separate your request into 2 applications. Each organization is only allowed to submit 1 APPLICATION.
Briefly describe the overall impact of the Coronavirus (COVID-19) on your organization. *
(Example: cancellation of fundraising events, increased demand for services, need for more staff, etc.)
Your answer
Amount Requested for Client Services (if none, type 0) *
If you are not requesting any, please type 0. DO NOT TYPE N/A.
Your answer
If you are requesting funds for CLIENT SERVICES, briefly describe the services to be delivered and the breakdown of funds. If not, type N/A. *
(Include how much the services will cost, when and where they will occur, how the target population will access them, and the length of time the services will be provided.)
Your answer
Estimate the number of clients that will be served.
Your answer
Amount Requested for Agency Resources (if none, type 0) *
This includes technology needs, staff time, and lost revenue. If you are not requesting any, please type 0. DO NOT TYPE N/A.
Your answer
If you are requesting funds for AGENCY RESOURCES, briefly describe the resources you need, how much they cost, and how they will impact your organization. If not, type N/A. *
Your answer
***SECTION 4: FUNDING SOURCES***
List current top five sources of revenue for your agency and the amount you receive from each source.(Example: foundations, financial institutions, government, etc.) *
Your answer
Which of the funders have provided a grant to your organization within the last three years? Check all that apply. *
This is informational only. Funding from one or none of the below does not preclude you from this current funding cycle.
Required
***SECTION 5: COLLABORATION***
If you are collaborating with other providers, please list them and describe how you are working together. *
Your answer
***SECTION 6: REPORTING***
Briefly describe your organization’s plan for documenting the use of Coronavirus (COVID-19) funds. *
Your answer
By pressing submit below, I confirm that I have the authority to submit a grant application on behalf of this agency.
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