FY 12-13 PSA Funding Request Packet

Leave This Blank:

Requesting Agency Information



Program Request Information


Number of Clients Served by Program:


Objectives of Program and Measures of Performance:

Example:


Objective 1:   Provide financial management training to clients in order to reduce reliance on financial assistance.

Measure of Performance:                                                              % of total clients receiving training
FY 10-11 Actual                                                                               New Program
FY 10-11 Estimate                                                                          50%
FY 10-11 Target                                                                              100%

Measure of Performance:                                                              % of client seeking assistance more than 1x per year
FY 10-11 Actual                                                                               Not Tracked
FY 10-11 Estimate                                                                          70%
FY 10-11 Target                                                                              60%





Note: If historical performance information is not available please indicate reason (i.e. new program, data not tracked, etc).







Submission Information and Instructions


This online form should be submitted along with a copy of the requesting agency’s current budget and the most recent audit report if not previously submitted to the City as required by a current agreement. If an audit report is not available, please submit the most current financial report available.

All agencies requesting funding of $25,000 or greater will be required to make a brief presentation to the City Council at a work session tentatively scheduled on May 3, 2012. Agencies requesting funding of less than $25,000 have the option of making a presentation to the City Council.

If your agency is requesting less than $25,000, please indicate below if you would like to be scheduled for a presentation time.






Certification

I certify that the information contained in this proposal is true and correct to the best of my knowledge and that I am authorized to make this application on behalf of the organization herein described for the purpose of receiving funding from the City of Temple, Texas.




The deadline for submission is April 2, 2012.
All requests must be received in our office by the deadline for consideration. No late submissions will be accepted.


Should you have any questions, please contact Brynn Reynolds at 254.298.5600 or via e-mail at breynolds@templetx.gov

 
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