HomeMy WebLinkAbout20071320.tiff RESOLUTION
RE: APPROVE MEMORANDUM OF UNDERSTANDING FOR PROMOTING
RESPONSIBLE FATHERHOOD PROJECT AND AUTHORIZE CHAIR TO SIGN -
SUMMITVIEW COMMUNITY CHURCH
WHEREAS,the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Memorandum of Understanding for the
Promoting Responsible Fatherhood Project between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County,on behalf of the Department of Social
Services, and Summitview Community Church, commencing April 1, 2007, and ending
September 30,2008,with further terms and conditions being as stated in said memorandum, and
WHEREAS,after review, the Board deems it advisable to approve said memorandum, a
copy of which is attached hereto and incorporated herein by reference.
NOW,THEREFORE,BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,ex-officio Board of Social Services,that the Memorandum of Understanding for
the Promoting Responsible Fatherhood Project between the County of Weld, State of Colorado, by
and through the Board of County Commissioners of Weld County,on behalf of the Department of
Social Services, and Summitview Community Church be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said memorandum.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 9th day of May, A.D., 2007, nunc pro tunc April 1, 2007.
BOARD OF COUNTY COMMISSIONERS
W OUN—Y, COLORADO
ATTEST: iattil � (e-
8,� ��..vid E. Long, Chair
Weld County Clerk to the r'
�dliam . Je)r�Pr -Te
Deputy Clerk to the Board /
Willia arcia �A
APPR AS TO F 1
obert D. Masde�
Th
unty Attorney < E \ /49-9-4/vvtiikiLt/
Douglas Rademacher
Date of signature: C-15-c7
2007-1320
SS0034
(p SS 05_ /G_ O7
DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
IBC.
GREELEY, CO. 80632
Website:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
W Fax Number(970)353-5215
COLORADO MEMORANDUM
TO: David E. Long, Chair Date: May 7, 2007
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services V" ( U
I V1
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RE: Memorandum of Understanding Between a Wed County
Department of Social Services and Summitview Community
Church
Enclosed for Board approval is a Memorandum of Understanding between the Weld County
Department of Social Services (Department)and Summitview Community Church (Summitview
Church). This Memorandum of Understanding was reviewed at the Board's Work Session of
April 30, 2007. Summitview Church received a grant of$100,000 through the Colorado
Department of Human Services to fund its Promoting Responsible Fatherhood Project. The
Memorandum of Understanding outlines the project's partnership between Summitview Church
and the Department.
The major provisions of the Memorandum of Understanding are as follows:
1. The period of this Memorandum of Understanding is April 1, 2007 through September
30, 2008.
2. The Summitview Church will promote activities and services for fathers to meet
outcomes that typify being a better father such as increased time with their families,
quality of time spent with families,and an increase in child support where applicable.
3. The Department will assist Summitview Church in its grant request by providing:
a. A cash match of$2,100 and $4,254 in-kind staff time; and
b. $19,000 to support Summitview Dad's Club special events and some o the costs
of the parenting/life skills classes, which will be funded through the
Department's Temporary Assistance for Needy Families/Community Investment
resources; and
c. client referrals, staff time to develop an evidence-based mentorship program with
Summitview, trainings to Summitview in business planning, CPA boekeepiS, n
and grant administration, and to assist in their collaborative efforts. m a
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2007-1320 cri =co—<
MEMORANDUM OF UNDERSTANDING BETWEEN
SUMMITVIEW COMMUNITY CHURCH
PROMOTING RESPONSIBLE FATHERHOOD PROJECT
AND
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
This Agreement is made and entered into this day of j\y v\ , 2007, between
Summitview Community Church, hereinafter referred to as SVC and the Weld County
Department of Social Services as a partner in the Promoting Responsible Fatherhood Project,
hereafter referred to WCDSS.
WITNESSETH:
WHEREAS, SVCC is the recipient of funding to provide the administration and delivery of a
Promoting Responsible Fatherhood Grant; and
WHEREAS, SVCC and WCDSS wish to establish collaboration in the Promoting Responsible
Fatherhood Project;and
NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein,
the parties hereto agree as follows:
1. Term:
The term of this Agreement between SVCC and WCDSS shall be for the period
beginning April 1, 2007 through September 30, 2008.
2. Geographic Areas To Be Served:
Intake and Assessment services shall be provided to residents of Weld County, Colorado.
3. WCDSS Responsibilities:
3.I.I.WCDSS will provide client referrals during the recruitment period August I s' 2007
through October Is' 2007,
3.I.2.WCDSS will provide staff time to support the development of an evidence based
mentorship program and a Local Delivery System which incorporates policies,
manuals, and protocol,
3.I.3.WCDSS will provide trainings to SVCC in Business Planning, CPA Bookkeeping,
and Grant Administration,
3.I.4.WCDSS will help to ensure the success of collaborative efforts between SVCC and
grant partners, the Family Education Network of Weld County and the University
of Northern Colorado, and faith based organizations,
3.1.5.WCDSS will provide payments as outlined in the attached budget from the TANF
Community Investment Program to SVCC based on the following plan:
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3.1.5.1. SVCC will submit all incurred expenses they wish to be reimbursed to
WCDSS by the Ill of each month with payment expected by the 10th of each
month,
3.1.5.2. SVCC will submit all expected proposed expenses they wish to be prepaid to
WCDSS quarterly:
• 1st Disbursement for April -June 2007; Disbursement date- April 23`d-
request for payment will need to be in by 3:00 p.m. April 20`h.
• 2nd Disbursement for July- September 2007; Disbursement date-July 2nd -
request for payment will need to be in by 3:00 p.m. June 29th.
• 3rd Disbursement for October- December 2007; Disbursement date-
December 3m-request for payment will need to be in by 3:00 p.m.Nov. 30th.
• 4th Disbursement for January- March 2008; Disbursement date-January 7th
- request for payment will need to be in by 3:00 p.m. January 4`h.
4. SVCC Responsibilities:
4.1.1.SVCC will use the funding received by WCDSS as described in B4 of the
Promoting Responsible Fatherhood Community Access Grant and as outlined in the
attached budget,
4.1.2.SVCC will present any requested line item change to the attached budget, which
must not change the total funding amount, in writing to WCDSS,
4.1.3.SVCC will provide progress and expense reports to WCDSS on a monthly basis
and provide semi-annual overall reports beginning July 12007 through September
30th, 2008,
4.1.4.SVCC will commit to participating in trainings provided by WCDSS in Business
Planning, CPA Bookkeeping, and Grant Administration,
4.I.5.SVCC will collaborate with WCDSS to develop an evidence based mentorship
program and a Local Delivery System which incorporates policies, manuals, and
protocol,
4.1.6.SVCC will agree to participate in the pre and post evaluations with the University
of Northern Colorado as well as provide WCDSS a copy of the University of
Northern Colorado's pre and post evaluations,
4.I.7.SVCC will collaborate with WCDSS to receive client referrals,
4.1.8.SVCC will collaborate with WCDSS and partnering agencies to ensure that the
following services and criteria are provided for program participants:
4.1.8.1. Eligible low income families (185%of poverty level); and
4.1.8.2. At-risk fathers between the ages of 17-25; and
4.1.8.3. Life skills, parenting, and marriage education and related services; and
4.1.8.4. Large group educational events, activities, childcare, and transportation,
4.1.9.SVCC will collaborate with the Family Education Network of Weld County to
provide intake, assessment, and referral; the Family Education Network of Weld
2
County will also screen participants for being legal citizens of United States and
assess for domestic violence,
4.1.10. SVCC will notify WCDSS on any revisions, amendments, or changes that may
occur on the Promoting Responsible Fatherhood Grant,
4.1.11. SVCC certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104.
requiring criminal background record checks for all employees and volunteers
connected to the program,
4.1.12. SVCC will abide by Equal Opportunity practices,
4.1.13. SVCC will collaborate as needed with our partner agency directors when
handling complaints within the collaborative effort to ensure that they are working
diligently and fairly in resolving the conflict.
5. Modification of Agreement:
All modifications to this Agreement shall be in writing and signed by both parties.
6. Assignment:
This Agreement shall be binding upon the parties hereto, their successors, heirs, legal
representatives, and assigns. Neither party may assign any of its rights/obligations
hereunder without the prior written consent of the other party.
7. Resolution of Disagreements:
If a problem/disagreement should occur, the WCDSS Director and the Fatherhood Project
Director should be notified immediately. If the problem/disagreement still can not be
resolved, it will be taken to a higher authority in both agencies.
8. Applicable Law:
WCDSS and SVCC agree to follow policies and procedures in accordance with Federal
and State regulations and other applicable laws and regulations.
9. Entire Agreement:
This Agreement constitutes the entire understanding between the parties with respect to
the subject matter hereof, and may not be changed or modified.
10. Waiver or Immunities/Third-Party Liability:
No portion of this Agreement shall be deemed to constitute a waiver of any immunities
the parties or their officers or employees may possess, nor shall any position of this
Agreement be deemed to have created a duty of care with respect to any persons not a
party to this Agreement.
11. Non-appropriation:
No portion of this Agreement shall be deemed to create an obligation on the part of
SVCC, the County of Weld, State of Colorado, to expend funds not otherwise
appropriated in each succeeding year.
12. Severability:
If any section, subsection, paragraph, sentence, clause or phrase of the Agreement is for
any reason held or decided to be unconstitutional, such decision shall not affect the
3
validity of the remaining portions. The parties hereto declare that they would have
entered into this Agreement and each and every section, subsection, paragraph, sentence,
clause, and phrase thereof irrespective of the fact that any one or more sections,
subsections, paragraphs, sentences, clauses, or phrases might be declared unconstitutional
or invalid.
13. Assurances:
See Exhibit C
IN WITNESS WHEREOF,the parties hereunto have caused this Agreement to be duly
executed as of the day and year first hereinabove set forth.
WELD COUNTY BOARD OF SUMMITVIEW COMMUNITY
€i KINTY COMMISSIONERS CHURCH
David E. Long, Chairperson Perry Paul d' g, Pastor
Elea MAY 9 07
44
116[ l l 3 -� CLERK TO THE BOARD
� . Cler the Board
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
JudOA. G „, o, Executive irect7
Li
4
EXHIBIT C
ASSURANCES
I. SVCC agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County, nor are they entitled to any employee benefits as Weld County
employees, as the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,
shall not be held liable for injuries or damages caused by any negligent acts or omissions of SVCC
or its employees, volunteers, or agents while performing duties as described in this Agreement.
SVCC shall indemnify,defend,and hold harmless Weld County,the Board of County
Commissioners of Weld County, its employees,volunteers,and agents. SVCC shall provide
adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request, SVCC shall provide Social
Services with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunity the parties or
their officers or employees may possess,not shall any portion of this Agreement be deemed to
have treated a duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of
Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsections,paragraph, sentence,clause,or phrase of this Contract is for any reason
held or decided to be unconstitutional,such decision shall not affect the validity of the remaining
portions. The parties hereto declare that they would have entered into this Contract and each and
every section, subsection,paragraph, sentence, clause,and phrase thereof irrespective of the fact
that any one or more sections, subsections,paragraphs,sentences, clauses,or phrases might be
declared to be unconstitutional or invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall
have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof.
7. SVCC assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed, color,sex,or national origin,be excluded from
participation in,be denied the benefits of,or be otherwise subjected to discrimination under this
approved Contract.
8. SVCC assures that sufficient,auditable,and otherwise adequate records that will provide accurate,
current, separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall
be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and
monitor SVCC.
9. All such records,documents,communications, and other materials shall be the property of Social
Services and shall be maintained by SVCC, in a central location and custodian, in behalf of Social
Services, for a period of four(4)years from the date of final payment under this Contract,or for
such further period as may be necessary to resolve any matters which may be pending, or until an
audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the four(4)year
period,or if audit findings have not been resolved after a four(4)year period,the materials shall
be retained until the resolution of the audit finding.
Page I of 3
10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall,
during business hours,have access to inspect any copy records, and shall be allowed to monitor
and review through on-site visits,all contract activities,supported with funds under this Contract
to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring
and evaluation of the performance of the Agreement shall be conducted by appropriate funding
sources. The results of the monitoring and evaluation activities shall be provided to the
appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal
representatives,and assigns. SVCC or Social Services may not assign any of its rights or
obligations hereunder without the prior written consent of both parties.
12. SVCC certifies that federal appropriated funds have not been paid or will be paid,by or on behalf
of SVCC,to any person for influencing or attempting to influence an officer or employee of an
agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member
of Congress in connection with the awarding of any Federal contract,the making of any federal
grant,the making of any federal loan,the entering into of any cooperative agreement,and the
extension, continuation,renewal, amendment, or modification of any Federal contract, loan,grant,
or cooperative agreement.
13. SVCC assures that it will fully comply with all other applicable federal and state laws. SVCC
understands that the source of funds to be used under this Contract is Child Welfare Regular
Administration funds.
14. SVCC assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,and declared ineligible,
or voluntarily excluded from, covered transaction by a federal department of agency.
b. Have not, within a three-year period of preceding this Agreement, been convicted of or
had a civil judgment rendered against them for commission of fraud or a criminal offense
in connection with obtaining, attempting to obtain,or performing a public(federal, state,
or local)transaction or contract under a public transaction; violation of federal or state
antitrust statutes or commission of embezzlement,theft, forgery,bribery, falsification or
destruction of records, making false statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government
entity(federal,state,or local)with commission of any of the offenses enumerated in
paragraph 11(b)of this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public
transactions(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Social
Services when the contractor also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest, it is not
necessary for the contractor to gain from knowledge of these opposing interests. It is only
necessary that the contractor know that the two relationships are in opposition. During the term of
the Contract, SVCC shall not enter any third party relationship that gives the appearance of
creating a conflict of interest. Upon teaming of an existing appearance of a conflict of interest
situation, SVCC shall submit to Social Services,a full disclosure statement setting forth the details
that create the appearance of a conflict of interest. Failure to promptly submit a disclosure
statement required by this paragraph shall constitute grounds for Social Services' termination, for
cause,of its contract with SVCC.
Page 2 of 3
16. SVCC shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient
in possession of SVCC shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with SVCC written policies governing access to,
duplication and dissemination of,all such information. SVCC shall advise its employees,agents,
and subcontractor, if any,that they are subject to these confidentiality requirements. SVCC shall
provide its employees, agents,and subcontractors, if any, with a copy or written explanation of
these confidentiality requirements before access to confidential data is permitted.
17. Proprietary information for the purposes of this contract is information relating to a party's
research,development,trade secrets,business affairs, internal operations and management
procedures and those of its customers,clients or affiliates,but does not include information(1)
lawfully obtained from third parties,(2)that which is in the public domain, or(3)that which is
developed independently. Neither party shall use or disclose directly or indirectly without prior
written authorization any proprietary information concerning the other party obtained as a result of
this Contract. Any proprietary information removed from the State's site by SVCC in the course
of providing services under this Contract will be accorded at least the same precautions as are
employed by SVCC for similar information in the course of its own business.
18. SVCC certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors, and sub-contractors
19. SVCC certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-
17.5-101, et seq. SVCC shall not knowingly employ or contract with an illegal alien to perform
work under this Contract or enter into a contract with a subcontractor that fails to certify to SVCC
that the subcontractor shall not knowingly employ or contract with an illegal alien to perform
work under this Contract. SVCC represents, warrants, and agrees that it (a) has verified that it
does not employ any illegal aliens, through participation in the Basic Pilot Employment
Verification Program administered by the Social Security Administration and Department of
Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-
IO2(2)(b). Contractor shall comply with all reasonable requests made in the course of an
investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If
Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq.,
Social Services may terminate this Contract for breach and Contractor shall be liable for actual
and consequential damages to Social Services.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if SVCC
receives federal or state funds under this Contract, Contractor must confirm that any individual
natural person eighteen(18)years of age or older is lawfully present in the United States pursuant
to C.R.S. 24-76.5-103(4) if such individual applies for public benefits provided under this
Contract. If SVCC operates as a sole proprietor, it hereby swears or affirms under penalty of
perjury that it (a) is a citizen of the United States or is otherwise lawfully present in the United
States pursuant to federal law, (b) shall produce one of the forms of identification required by
C.R.S. 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by
C.R.S.24-76.5-103 prior to the effective date of this Contract.
Page 3 of 3
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SUBMIT THIS PAGE
STATE OF COLORADO
DEPARTMENT OF HUMAN SERVICES
PROMOTING RESPONSIBLE FATHERHOOD COMMUNITY ACCESS GRANT
REQUEST FOR APPLICATION(RFA)—Funding Cycle April I,2007—September 30,2008
IMPORTANT: Applications submitted in response to this RFA MUST be accompanied by this REQUEST FOR
APPLICATION SIGNATURE PAGE. Applicants should carefully read this entire RFA document and instructions
before submitting an application. Applications must be signed in ink. Instructions are included in a separate
document,which may be found on the website htto://www.cdhs.state.co.us/coworks/index.htm.
TYPE OF APPLICANT(PLEASE CHECK ONE):
® Community/faith-based organization with 501(c)3 or 509(a)l tax status(must complete shaded areas of
application)AND 2006 operating budget of$300,000.00 or less AND six(6)or fewer full-time equivalent
employees.
❑ Community/faith-based organization without 501(c)3 or 509(a)l status AND 2006 operating budget of
$300,000.00 or less AND six(6)or fewer full-time equivalent employees.
❑Community/faith-based organization with 501(c)3 or 509(a)I tax status(must complete shaded areas of
application)AND 2006 operating budget of$300,000.00 or more OR more than six(6)full-time equivalent
employees.
❑Community/faith-based organization without 501(c)3 or 509(a)l status AND 2006 operating budget of
$300,000.00 or more OR more than six(6) full-time equivalent employees.
❑ County department of human/social services.
f ❑ Other governmental agency. Please indicate:
❑Other,please describe:
A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA
TYPE ONLY WITHIN TABLE CONTAINED BELOW. DO NOT CHANGE TABLE SIZE.
A. SIGNATURE AND CONTACT INFORMATION TABLE
Full Legal Name of Applicant: Summitview Community Church of Greeley
Physical Address: 801 37th St
Mailing Address(if different than
above):
City: Evans, CO
Zip Code: 80620
County: Weld
Phone: 970-356-4777
Fax:
Email: office@summitviewcommuniy.com
Website:ite: www.summ itviewcom mun ity.corn
FEIN or SSN: 48-1262838
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SUBMIT THIS PAGE
A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA(CONTINUED)
TYPE ONLY WITHIN TABLE CONTAINED BELOW. DO NOT CHANGE TABLE SIZE.
Name of Authorized Official: Perry Paulding
Signature of Authorized Official:
Date: 2/15/07
Title of Authorized Official: Pastor
Total Funding Request: $100,000.00
Director's Name: Mike Bonnell
Director's Phone: 970-302-9965
Director's Email: mike@bonnellfencing.com
Fatherhood Program Contact Name: Mike Bonnell
Fatherhood Program Contact Title: Program director
Fatherhood Program Contact Phone: 970-302-9965
Fatherhood Program Contact Email: mike@bonnellfencing.com
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THISPAGE.
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A3. Provide a summary of the fatherhood project, including an outline of a plan of action that describes the
scope and detail of how the proposed work will be accomplished. (Limit response to 200 words.)
This program is based on the premise that fathers need more input than can typically be provided in a classroom
setting. Our goal is to impact 25 fathers by training 15 mentors to work with an initial 10 clients. We will have
weekly contact with these clients to develop positive relationships. These mentoring relationships will reinforce
classroom instruction and provide an opportunity for one-on-one input into the lives of at-risk dads.
I. Clients are obtained from the community, Social Service programs,churches, Pregnancy Resource
Center, etc...
II. Clients assessed at Head Start, healthy marriage demonstration grant
III. University of Northern Colorado(UNC)provides evaluation
IV. Mentors trained
V. Clients trained
a. Classroom instruction(Once per month): Clients will be taught through a DVD series or similar
method that trains fathers in critical areas such as life skills, parenting,and marriage. Approved
curriculum will include topics such as:
i. Drugs and alcohol
ii. Child nutrition
iii. Abuse and anger
iv. Money management
v. Work ethic
vi. Taking responsibility
vii. Marriage building
viii. Positive fathering/parenting
ix. Mentoring(Twice per month)
x. Dad's Club activities(Every other month)
VI. UNC completes ongoing evaluation
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SUBMIT THIS PAGE
A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
A3a. If available,attach a sample of applicant's brochure, promotional, marketing materials,or fact sheet that
highlight relevant services potentially funded under this grant. (PLEASE LABEL THIS ATTACHMENT
A3a.)Unavailable/new program
TYPE ONLY WITHIN TABLE CONTAINED BELOW. DO NOT CHANGE TABLE SIZE.
A4. FATHERHOOD PROGRAM STATISTICS-IF AVAILABLE(CALENDAR YEAR 2006)
Please only submit known statistics.
Total#of Families Served: Unavailable/new program
Total#of Custodial Fathers Served: Unavailable/new program
Total #of Non-Custodial Fathers Served: Unavailable/new program
Total # of Families Served with incomes under$75,000 per year: Unavailable/new program
# of Community Education Presentations: Unavailable/new program
#of Active Volunteers: Unavailable/new program
A5. Provide an applicant history including how long has the applicant been providing services to promote
responsible fatherhood. (Limit response to 200 words.)
This particular fatherhood program is new and under development. However Summitview Community Church has
been promoting responsible fatherhood since its inception over nine years ago. One way this has been achieved is
through marriage, parenting, and finance seminars. We have also been involved in premarital counseling, family
counseling, and marriage counseling throughout our existence. The organization also funded the writing and printing
of a book on child rearing authored by one of the pastors in 2006. We currently have a weekly men's group where
we have been learning the skills necessary to work with the unique issues that men face. The church also uses a
small group structure that fosters individual input into and care for the individuals in the church. The model has
equipped us to use a similar model to mentor at-risk dads.
A6. What relevant experience does the applicant have in working with fathers?(Limit response to 200
words.)
The program director, Mike Bonnell, is a father of four children. He has a passion for his own kids and a desire to
see other fathers take responsibility for their families. He is an entrepreneur,and has worked with and informally
mentored many men, most of whom are at-risk,and similar to the clients we will be working with. Some of these
men have made significant life choices that will help them be good fathers. Such changes include choices to pursue
marriage, further education,and to develop a stronger work ethic.One father that he has mentored intensively for
several years has worked through ongoing relationship struggles with his girlfriend (the mother of his child), and is
getting married next month. Such mentoring the father, mother, child, and ultimately our society. Mike and his wife
are currently volunteering at the Pregnancy Resource Center teaching a parenting class that is also composed
primarily of at-risk families.
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A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
A7. Please use the space below to clearly identify the physical,economic,social,financial, institutional and/or
other problems requiring solution from a fatherhood perspective in the applicant's community or
communities. Include information such as data related to local community fatherhood program needs,
which will assist the selection committee in better understanding the applicant. (Limit response to 200
words.)
PROBLEM 1: Rapid population growth has outpaced services.
Denver's suburban population is expanding into the southern part of Weld County, making it one of the 50
fastest growing counties in the nation. From 2000 to 2005,the county grew 27%to 228,934 people, on top
of 37%growth between 1990 and 2000. Towns in the southern part of the County have grown by 300%to
600%since 1990. Services have not kept pace with this explosive growth.
PROBLEM 2: Language is a barrier to receiving services.
Language is an indicator of complicated barriers. Latino citizens have played a key role in Weld County
for generations,and recent Census figures indicate that the County's Latino population is growing faster
than other populations. This group makes up 29%of Weld County's population.
PROBLEM 3: Low-income families face challenges as a result of changes in the County's economy,rising housing
prices,and a lack of formal education
Census Bureau figures(2003)indicate that 10%of Weld County families live below the poverty level. In
2000,28%of households had an income under$25,000, well below 200%of the poverty line($32,200 for
a famil of three). Unstable em to ment is revalent.
A8. List the other promoting responsible fatherhood services providers also serving the applicant's geographic
area(if known)and nature of collaborative relationship(if applicable). (Limit response to 200 words.)
There are existing community services in place designed to develop parenting skills and promote healthy marriages.
One such program we are collaborating with is the Healthy Marriage Demonstration Grant in Weld County.
However,these programs are not specifically geared towards fathers. The only organizations in the county that are
currently promoting responsible fatherhood are churches and faith-based organizations. Summitview Community
Church has a large network of faith-based organizations and is willing and able to collaborate with these
organizations as the fatherhood program develops to enhance our program and to provide assistance in their efforts
to duplicate our program if desired.
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See attachment A 12
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B. SERVICE PROVISION PROCEDURES
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
B I. How will potential clients be referred to applicant's fatherhood program? (Limit response to 200 words.)
Clients will be referred to the fatherhood program through the Department of Social Services' Assistance Payment
Division(Child Support Division)and the Department of Human Services(Head Start). The applicants will also be
collaborating with the United Way of Weld County Community Partners,the Pregnancy Resource Center and area
churches for referrals.
B2. What(if any)provisions does the applicant have in place to assure that fathers engage in program services
voluntarily?(Include in this answer how the applicant handles cases that are court-mandated referrals.
Limit response to 200 words.)
Clients will be notified verbally of the voluntary nature of this program by the program director during the initial
recruiting process. They will be reminded again verbally and in writing by the Department of Human Services
during the intake, assessment and screening process. All referral sources and applicants will be given written and
verbal assurances up front that participation must be voluntary.
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B. SERVICE PROVISION PROCEDURES(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
B3. Describe the applicant's policy regarding the client grievance process or handling of client complaints.
(Limit response to 200 words.)
Complaints must be dealt with immediately and effectively in a forthright manner. We will collaborate as needed
with our partner agency directors when handling complaints to ensure that we are working diligently and fairly in
resolving the conflict. Depending on the nature of the complaint,the process for conflict resolution will generally
flow as follows: The program director will ask the client or mentor to present their concerns individually with the
person or persons with there is conflict first and attempt to resolve the problem themselves. If the conflict has not
been satisfactorily resolved after meeting with the person individually,the program director will meet with both
parties to mediate and work through the conflict. If these efforts are not effective and the complaint escalates to a
level that cannot be satisfactorily resolved, the program director will need to discern which party is in the wrong and
will act as needed to remove the client or mentor from the program.
B4. Describe the applicant's plan for retaining clients. (Limit response to 200 words.)
Through our collaborative partnerships with the Weld County Department of Social Services, we will provide a
stipend for completing the intake,assessment and screening to initially encourage the client to enter into the
program. Upon joining the program, we will continue to provide stipends in the form of food,associated childcare
costs as related to the program, recreational activities and various awards. We will use the stipends initially to
motivate the client's interest while providing us the opportunity to develop personal mentoring relationships with the
client. Relationships that develop within the group and specifically positive mentoring relationships that develop
will ultimately be the primary contributor to client retention.
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B. SERVICE PROVISION PROCEDURES(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
B5. What is the applicant's policy with regard to non-proselytization for services provided under this grant? (If
applicable, include in this answer how applicant provides alternatives to mandatory religious participation
such as worship, religious instruction or prayer. Limit response to 200 words.)
The grant money will not be used to support inherently religious activities. If participants are invited to any religious
activities they will be reassured that they their involvement in our fatherhood program will in no way be jeopardized
if they do not choose to participate. In a similar manner, should a staff person or mentor participate in a religious
activity in the presence of our clients,they will be required to reassure the clients that their involvement in our
fatherhood program will in no way be jeopardized if they do not choose to participate. We will not use Federal
funds to purchase or develop religious materials. If someone asks about personal faith we will answer briefly and
offer to discuss the matter outside of the program. Those on staff will be employed with the understanding that they
are delivering a federally-funded service,and that they are not to perform religious worship, instruction, and
proselytization while working in this capacity. We will not discriminate against eligible clients based on their
religious beliefs. We understand that a violation of this policy could result in legal action such as loss of grant funds,
payment of damages, and even criminal prosecution.
B6. What is the applicant's commitment that funds set forth in this grant will be used only for the services
described above(specifically address the applicant's policy on involvement in child visitation/custody
proceedings, lobbying and legislative advocacy. (Limit response to 200 words.)
The Contractor certifies that federal appropriated funds have not been paid or will be paid, by or on behalf of the
Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member
of Congress,an officer or employee of Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contract,the making of any federal grant,the making of any federal loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, loan,grant, or cooperative agreement.
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B. SERVICE PROVISION PROCEDURES(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
B7. Describe how the applicant will provide services in the following ten areas and if there is a need for
technical assistance and/or training. Please describe, if known, what types of training/assistance is needed.
Responses are REQUIRED for B7b, B7c, B7e and B7f. Remaining service areas are optional.
B7a. (OPTIONAL SERVICE AREA) Young fathers or too-early fatherhood. (Limit response to 50 words.)
Young, at-risk fathers between the ages of 17-25 will be the most heavily targeted group in this program. While
there are always exceptions to the rule,past experiences have indicated that younger fathers are generally more open
to considering and implementing positive input for the betterment of their families.
B7b. (REQUIRED SERVICE AREA)Help fathers establish positive relationships with their children
(specifically how the applicant encourages fathers to be positive non-violent role-models and encourages
fathers to be nurturing). (Limit response to 50 words.)
We will meet as a large group once/month in a class setting to discuss these topics. The topics will be addressed
again when mentors meet separately with the clients. The mentors will be challenged to provide a firsthand example
of a nurturing and non-violent life.
B7c. (REQUIRED SERVICE AREA) Improving fathers' economic circumstances. (Limit response to 50
words.)
We will provide a class on money management and budgeting and rely heavily on the mentor/client relationship to
coach the clients through financial decisions when possible to help the client begin to recognize good and bad
financial decisions. We will also provide direction in locating work opportunities as needed.
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B. SERVICE PROVISION PROCEDURES(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
B7. CONTINUED—Describe how the applicant will provide services in the following ten areas and if there is
a need for technical assistance and/or training. Please describe, if known, what types of training/assistance
is needed. Responses are REQUIRED for B7b, B7c, B7e and 87f. Remaining service areas are optional.
B7d. (OPTIONAL SERVICE AREA)Community education programs(specifically how the applicant increases
public awareness about responsible fatherhood). (Limit response to 50 words.)
We will design and distribute brochures about our program throughout the community. We will utilize free public
service announcement in the media. We will maximize our relationship with Weld County to collaborate and help
promote responsible fatherhood and our program. We would like some additional training in this area.
B7e. (REQUIRED SERVICE AREA) Assesses potential fathers for domestic violence and provides assurances
that services promote the safety and well-being of fathers' partners and their children. (Limit response to 50
words.)
Our partner, Weld County Human Services(Head Start), is currently screening for domestic violence and providing
assurances in the Healthy Marriage Demonstration Grant in Weld County. The participants in the Promoting
Responsible Fatherhood program will go through Head Start for intake,assessments,domestic violence screening
and referral.
B7f. (REQUIRED SERVICE AREA)Collaborations or dynamic ongoing relationships with local TANF
offices,child support enforcement,child welfare,domestic violence crisis centers, substance abuse
programs, mental health programs, health care services or other human services or community-based
entities. (Limit response to 50 words.)
We are collaborating with Weld County Department of Human Services(Head Start), Weld County Department of
Social Services, the University of Northern Colorado, Weld County Healthy Marriage Demonstration Grant, Island
Grove Substance Abuse Center,North Range Behavioral Health,the United Way, and A Woman's Place(DV crisis
center).
B7g. (OPTIONAL SERVICE AREA)Fathers who have children with disabilities. (Limit response to 50 words.)
We will make accommodations for clients with disabilities.
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B. SERVICE PROVISION PROCEDURES(CONTINUED)
FOR THE FOLLOWING QUESTIONS,PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED AND DO NOT EXPAND B YOND ON P AG F OR INFORMATION RESPONSES AS
ALL QUESTIONS ON ON THIS PAGE.
INDICATED
B7. CONTINUED—Describe how the applicant will provide services in the following ten areas and if there is
a need for technical assistance and/or training. Please describe, if known, what types of training/assistance
is needed. Responses are REQUIRED for B7b, B7c, B7e and B7f. Remaining service areas are optional.
B7h. (OPTIONAL SERVICE AREA)Single custodial fathers. (Limit response to 50 words.)
We are providing childcare during group classes to allow single custodial fathers the opportunity to attend class.
The mentor and client can work together to schedule a meeting time that meets the custodial needs of the father.
B7i. (OPTIONAL SERVICE AREA)Non-residential fathers. (Limit response to 50 words.)
We believe that combining the parenting and life skill classes with an effective mentoring program will prove to be
highly valuable to both residential and non-residential fathers.
B7j. (OPTIONAL SERVICE AREA) Recipients of child protective services from a county department of
human social services. (Limit response to 50 words.)
We will be receiving referrals directly from the Weld County Department of Social Services' Child Protective
Services division.
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C. COMMUNITY ACCESSIBILITY PLAN
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
Cl. Who are the underserved populations in the catchment area?(example include populations underserved
because of ethnicity,race, religion,culture,age, language barrier, sexual orientation or geographic location.
Limit response to 200 words.)
The lack of fatherhood programs in our community underserves various ethnic groups: the undereducated,the
impoverished,and the young fathers.
Census Bureau figures(2003)indicate that 10%of Weld County families live below the poverty level. In 2000,
28%of households had an income under$25,000,well below 200%of the poverty line($32,200 for a family of
three). Unstable employment is prevalent. Many jobs have traditionally been low-paid agricultural work. As the
County becomes more urban, these jobs become less common. Agricultural workers often lack skills that are
relevant in the new economy,and Greeley recently gained the unwanted distinction of having the lowest per capita
income in Colorado. Lack of education is a significant barrier to economic self-sufficiency,as 10%of Weld County
residents have less than a 9th grade education.
Latino citizens have played a key role in Weld County for generations,and recent Census figures indicate that the
County's Latino population is growing faster than other populations. This group makes up 29%of Weld County's
population. 18%of the County's population speaks Spanish at home, and 9%speaks English less than"very well."
Cla. How did the applicant determine the underserved populations? (Limit response to 200 words.)
Denver's suburban population is expanding into the southern part of Weld County, making it one of the 50 fastest
growing counties in the nation. From 2000 to 2005,the county grew 27%to 228,934 people, on top of 37%growth
between 1990 and 2000. Towns in the southern part of the County have grown by 300%to 600%since 1990.
Services have not kept pace with this explosive growth. The entire County has access to United Way's"211"
information system, and from July 2005 - May 2006,there were 18,460 calls to that system. Only 203 came from
the southern part of the County and 24%of these callers did not receive services. According to the 2006 Weld
County Department of Social Services and assistance payments cases in Weld County,there are 6,360 families
receiving medical assistance,3,659 families receiving food stamps,and 5,129 families applying for LEAP.
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C. COMMUNITY ACCESSIBILITY PLAN(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
C2. What specific activities has the applicant accomplished in the past 12 months to provide information and
services to each of these groups defined as underserved? (Limit response to 200 words.)
This is a new program. However,the applicant(Summitview Community Church)and the program director(Mike
Bonnell)have been actively involved in and promoting mentoring programs and offering parenting classes on an
ongoing basis for the past several years.
C3. List the percentage of people of color, bilingual and bicultural staff, volunteers and Board of Directors
members associated with the operation of the applicant's fatherhood program.
People of Color Bilingual Bicultural
Staff 18% 20%
Volunteers 30-35% 15-20%
Board of Directors
C3a. What recruitment efforts has the applicant made to assure staff, volunteer and Board of Directors(or
advisory board)representation reflects the community to be served?(Limit response to 200 words.)
This program was developed in collaboration with many partners so that we will have a multi-cultural staff which in
Greeley is 29%Latino and 71%Caucasian. Specifically, bi-lingual job descriptions were developed and
recruitment will cover our multi-cultural community
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C. COMMUNITY ACCESSIBILITY PLAN(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
C4. Is the applicant's office physically accessible to persons with disabilities(as described under the Americans
with Disabilities Act)?(Examples include TTY phone line, physical accessibility.)
TYPE AN"X" TO THE LEFT OF RESPONSE: X YES NO
C4a. If yes, please describe the features that promote accessibility. (Limit response to 200 words.)
All entrances into Summitview Community Church are at street level and all restrooms are wheelchair accessible.
Handicap parking is provided in close proximity to the doors for easy access into the facility.
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C. COMMUNITY ACCESSIBILITY PLAN(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
C4b. If no to question C5, what plans are in place to improve the accessibility to the office to provide services
for persons with disabilities?(Limit response to 200 words.)
Not applicable
C5. What hours are the applicant's services available and how does the applicant's hours of service meet the
needs of fathers who work? (Limit response to 200 words.)
This program is designed on the premise that the vast majority of fathers involved in the program work during the
day. To effectively meet the needs of working fathers,classes and events will be held during the evenings or
weekends. We can be flexible in choosing an evening or time to meet after we have a better understanding of our
client base and their needs. Mentoring relationships will provide for additional flexibility around working schedules
since only two people are involved in scheduling a specific time to meet. The program director will be available on
an on-call basis 24 hours/day.
•
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D. APPLICANT STRUCTURE/RESOURCES
FOR THE FOLLOWING QUESTIONS,PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
DI. Attach an organizational chart with each copy of the application. The chart should indicate both paid staff
and volunteer positions within the organization. Each position should be clearly marked. (PLEASE
LABEL THIS ATTACHMENT DI.)
D2. Attach a dated list of members of the CURRENT Board of Directors, if available. If applicant is a
government agency, submit list of members of governing body(i.e. county commissioners). (PLEASE
LABEL THIS ATTACHMENT D2.)
D3. Attach CURRENT job descriptions for all positions that are providing direct services to fathers under this
grant(paid staff and volunteer.) (PLEASE LABEL THIS ATTACHMENT D3.)
D4. Provide fiscal information as outlined below.
D4a. Identify who has fiscal or financial responsibility/oversight within the applicant's fatherhood program.
Name Title
Staff person with fiscal or financial responsibility Mike Bonnell Program Director
and oversight:
Staff person with fiscal or financial responsibility
and oversight:
Board of directors person with fiscal or financial Perry Paulding Pastor, board member
responsibility and oversight:
Board of directors person with fiscal or financial
responsibility and oversight
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D. APPLICANT STRUCTURE/RESOURCES(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
D4b. What procedures are in place to assume board fiscal or financial oversight? (Examples include monthly
fiscal reports, finance committee meetings,etc... Limit response to 200 words.)
The program director will meet quarterly with the board of Summitview Community Church of Greeley. At these
meetings the progress of the program and the use of funds to further the objectives of the program will be discussed
and evaluated. At this quarterly meeting,the program director will provide a financial report to each of the board
members.
The program director will also meet in a similar fashion with our collaborative partners,specifically the Department
of Social Services. These meetings will occur as requested by the Department of Social Services, with a minimum
requirement of meeting semi-annually. The same reports will be provided to attendees at these meetings, with the
addition of reports showing how in-kind funds are being utilized.
D5. What additional resources does the applicant have available to provide the proposed promoting responsible
fatherhood services? (Examples include personnel, funding, in-kind contributions,etc... Limit response to
200 words.)
Personnel —one person from the Department of Human Services,one person from Weld County Social Services,
one person from the University of Northern Colorado,multiple volunteers from Summitview Community Church,
cash match of$2,100 from Weld County Social Services, $4254 in-kind staff contribution from the Department of
Social Services,$996 in-kind contribution from the Department of Human Services for case management and
$3,750 in-kind contribution from the University of Northern Colorado for pre and post evaluation
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D. APPLICANT STRUCTURE/RESOURCES(CONTINUED)
FOR THE FOLLOWING QUESTIONS,PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
D6. Explain the training the applicant's staff and volunteers have received regarding promoting responsible
fatherhood. Include in this response the process used for new staff and board member orientation and
training,training on cross-cultural topics,accessibility and domestic violence. Also provide information on
any training needed that is currently unavailable based on applicant's resources. (Limit response to 200
words.)
A Woman's Place provides free domestic violence issues training. The Department of Social Services has agreed to
provide training on topics such as Building Trusting Relationships with Faith-Based Organizations, Public
Education and Marketing Ideas for the Promoting Responsible Fatherhood Program, How to Access the Weld
County Department of Social Services for Resources and Referral,Guidance to Faith-Based and Community
Organizations on Partnering with the Federal Government, Mentorship and Volunteer Capacity Building in the
Promoting Responsible Fatherhood Project. The Department of Social Services has also agreed to provide training
directly or refer us to their large number of resources available for additional training needs that may arise.
D7. Describe the actions the applicant has taken to diversify funding sources. (Limit response to 200 words.)
Weld County Department of Social Services has agreed to provide$2,100 in cash support. Weld County Department
of Human Services(Head Start)will provide intake, assessments and domestic violence screening in-kind. The
University of Northern Colorado will provide pre and post evaluation to determine program effectiveness in-kind.
The applicant(Summitview Community Church)will provide a meeting facility and volunteer hours in-kind.
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E. PROGRAM EVALUATION
FOR THE FOLLOWING QUESTIONS,PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
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INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
E I. Define the outcome or impact the applicant intends to achieve through services provided under this grant.
(Limit response to 200 words.)
Our ultimate impact is that we believe our clients will be better fathers as a result of involvement in this program.
Some outcomes that typify being a better father include increased time with their families, quality of time spent with
families, and an increase in child support where applicable. We also expect to see fathers increase their percent of
time employed, length of time employed,and general increased value to their employers. There should also be a
decrease in unsecured debt. We also expect an increase in marriages and long term commitment to families for
fathers who are not currently committed to the mothers of their children. For married fathers.there should be a
decrease in divorce. There should also be a decrease in destructive behavior such as alcohol abuse and exposing
their children to second-hand smoke. There should be an increase of healthy communication throughout the family,
and a decrease of angry and harmful communication and actions. Fathers will also learn to use appropriate forms of
training and correction. In the long term we expect this to produce healthy,well adjusted children from homes that
were formally at risk.
E2. Explain how the applicant will measure the degree to which the promoting responsible fatherhood grant-
funded activities are achieving the intended outcome or impact. (Limit response to 200 words.)
We will collaborate with the University of Northern Colorado(UNC)to develop the appropriate evaluation
measurements and methods to perform pre and post program evaluation. As part of our monthly fatherhood
workshops, Summitview Community Church will also have monthly surveys to monitor progress towards desired
outcomes.
Expected and measurable outcomes upon successful completion of program:
20%increase in quality time spent with children(active interaction-read book, play children's games, etc)
20% increase in quality time spent with partner(active interaction-dinner, discussion, family time)
10%increase in child support payments
15%increase in hours employed
I 5%increase in client income
15%decrease in unsecured debt
40%decrease in time spent smoking in front of children
40%decrease in escalating unhealthy disagreements to the point of yelling or arguing in the presence of children
10%decrease in drug and alcohol use
For additional information on our joint efforts with UNC, please see attached letter labeled E2.
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F. DEMONSTRATED COMMUNITY SUPPORT,COOPERATION AND COLLABORATION
Demonstrated community support,cooperation and collaboration can be substantiated by letters of support from
appropriate entities. The letters must support the application and describe the specific working relationship between
the applicant and the entity providing the letter. Examples include: county human services(child protection, TANF,
child support enforcement), social service organizations or other fatherhood programs. Applicants must submit
three(3)letters as outlined below. The letters must be dated within six months of the application deadline and must
be included with the application. Letters sent under a separate cover will not be considered.
Fl. One(1)and no more than one letter that provides general support for the application. (PLEASE LABEL
THIS LETTER Fl.) List the name of the supporting individual and his/her affiliation or supporting
organization.
Thomas Selders—Mayor of the city of Greeley
F2. One(1)and no more than one letter that documents a current and ongoing collaborative or cooperative
relationship. (PLEASE LABEL THIS LETTER F2.) List the name of the supporting individual and
his/her affiliation or supporting organization.
Judy Griego—Director, Weld County Department of Social Services
F3. One(1)and no more than one letter that documents a developing or current, ongoing collaborative or
cooperative relationship with a local domestic violence organization(crisis centers for victims and abuser
intervention services). This letter must indicate the nature of the collaborative relationship and should
outline the goals of the collaborative relationship. (PLEASE LABEL THIS LETTER F3.) List the name of
the supporting individual and his/her affiliation or supporting organization.
Walter Speckman—Executive Director, Weld County Department of Human Services- intake,assessment, domestic
violence screening and referral. We felt it necessary to also include a letter of collaboration from North Range
Behavioral Health on the back of letter from Human Services to document their cooperation as pertains to domestic
violence.
F4. One(I)and no more than one letter that provides client testimonial. This letter must be no more than one
page and should not identify the client. (PLEASE LABEL THIS LETTER F4.)
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G. APPLICANT FINANCIAL INFORMATION
Note: If the applicant provides other program services in addition to promoting responsible fatherhood,the applicant
must submit only the financial information that reflects the portions of the budget being used for fatherhood
programs.
G I. Attach a 2006 year-end financial statement. (PLEASE LABEL THIS ATTACHMENT GI.)
The fatherhood program is a new program. No historical financial data exists at this time for this program.
G2. Attach a 2007 year-to-date financial statement. (PLEASE LABEL THIS ATTACHMENT G2)
The fatherhood program is a new program. No historical financial data exists at this time for this program.
G3. Attach the applicant's most recent financial review or audit. Regardless of budget size, all submitted audits
must be dated 2003 or later. (PLEASE LABEL THIS ATTACHMENT G3.)
The fatherhood program is a new program. No historical financial data exists at this time for this program.
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G4. Complete the Current Revenue and Expense Form below. (DO NOT CHANGE THE SIZE OF THE
FORM.)
The fatherhood program is a new program. No historical financial data exists at this time for this program.
G4. CURRENT REVENUE AND EXPENSE FORM
Applicant Name:
Relevant Dates:
Revenue
LIST SOURCES AS NECESSARY AMOUNT
United Way
Foundation Grants
Local fundraising activities/events
Donations(individuals,churches,organizations)
TOTAL REVENUE
Expenses LIST ITEMS AS NECESSARY AMOUNT
Personnel(including benefits)
Contract staff(therapists,temporary staff,etc...)
Equipment(copiers, faxes,computers)
Rent/mortgage/utilities/maintenance
Communications(including,phones, answering services,
beepers)
Insurance
Fundraising expenses
Professional Services(audit,consulting)
Training(board, staff,volunteers)—registration fees only
Staff travel expenses
Program supplies and materials
Administrative supplies and materials
Books and subscriptions
Memberships
TOTAL EXPENSES
Reserve from
Previous Year
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H. SCOPE OF REQUEST INFORMATION
Complete the appropriate Scope of Request page(s)for each of the Eligible Service Components for which funding
is being requested. The two eligible service components are 1)fatherhood parent skills training and 2)healthy
marriage/couples relationship training.
Directions:
I. Fill in the total amount requested where requested. This is the TOTAL amount for this service
component ONLY. Leave blank if funding is not requested for that service component.
2. Complete the goals and objectives statements for each component that is relevant to the applicant's
funding request.
3. Complete the timeline for each component that is relevant to the applicant's funding request.
4. On the budget form, fill in the AMOUNT for each budget category for which funding will be used.
Under PERSONNEL, fill in the job title and the amount requested for each position. Leave the space
blank if funds are not requested for that item. For budget items not listed, fill in the line item name in
the OTHER category.
5. Applicants may request up to $100,000.00 TOTAL,distributed between both the eligible services
components or within only one component. SUBMIT ALL PAGES, EVEN IF SERVICE
COMPONENT DOES NOT APPLY TO REQUEST.
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H2. SCOPE OF REQUEST-PARENT SKILLS TRAINING
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H2a. TOTAL AMOUNT REQUESTED FOR PARENT SKILLS TRAINING:
I $100,000.00
H2b. GOALS AND OBJECTIVES
Goal #1: (Limit response to 50 words.)
Train fathers in family relationships
Objectives: (Limit response to 100 words.)
I) Training fathers to take responsibility for the economic,emotional, and educational well-being of their
families—including the importance of marriage and two parent families
2) Having fathers learn how to help children establish boundaries
3) Teaching fathers how to develop a loving and supportive atmosphere in their homes that will help their
children develop healthy self-images
a. 20%increase in quality time spent with children and partner
4) Helping fathers learn basic child care awareness to develop safer and healthier home environments
5) Helping fathers to make healthy choices when it comes to major life decisions.
Goal #2: (Limit response to 50 words.)
Help fathers develop life skills that will directly benefit their families
Objectives: (Limit response to 100 words.)
1) Teaching the importance of work,job stability, and providing for their families
a. 15%hours employed increase
b. 10%child support increase
c. 15%unsecured debt decrease
d. 15% income increase
2) Learning how to foster a healthy home environment through anger management
a. 40%decrease in escalating unhealthy disagreements to the point of yelling or arguing in the
presence of children
3) Educating about the harmful effects of smoking, drugs, and alcohol on them and their family members
a. 40%decrease in time spent smoking in front of children
b. I0%decrease in drug and alcohol use
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H2. SCOPE OF REQUEST-PARENT SKILLS TRAINING (CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H2c. What is the applicant's proposed service provision timeline(i.e. what is the sequence of services provided,
are services ongoing or are they offered at specific times of the year)? Please indicate a timeline of services
for each of the quarters of the contract listed below. Limit responses to 50 words per quarter.
Quarter#1 April 1,2007—June 30,2007:
We will begin the initial screening of mentors, finalize the program development, and finish the curriculum
selection. We will also develop brochures and any needed promotional and informational materials in this initial
phase.
Quarter#2 July 1,2007-September 30,2007
In this phase we will do the mentor training, which will occur a weekly or biweekly pace, which is accelerated when
compared to the client training. We will also perform the initial screening of referred clients to obtain our first wave
of men to train and mentor. Evaluation begins.
Quarter#3 October 1,2007—December 31, 2007
We will start our client training. A key aspect to this phase will be to start developing mentor and client
relationships. Evaluation continues.
Quarter#4 January 1,2008—March 31,2008
In this phase we will continue client training. We will also use this tame to evaluate perceived progress toward
objectives and outcomes,and make necessary adjustments to ensure the greatest possible impact with our efforts.
Evaluation continues.
Quarter#5 April 1,2008—June 30,2008
Ongoing client training will be continued. Evaluation continues.
Quarter#6 July I,2008—September 30,2008
Ongoing client training will be continued. Successful clients will be recruited to volunteer as mentors in the next
phase of the program. Final evaluation will be performed.
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H2. SCOPE OF REQUEST-PARENT SKILLS TRAINING (CONTINUED)
H2d. PROPOSED PARENT SKILLS TRAINING BUDGET-DO NOT CHANGE SIZE OR FORMATTING
OF THIS FORM.
Applicants may request funds based on the categories below. Personnel requests must be for direct services staff
ONLY. Direct services staff must provide support and delivery of core services to the target population of this
grant. Staff who provides administrative support are not eligible for funding under this grant. Miscellaneous
expenses must not be more than 10%of total request. Overhead expenses such as rent and utilities are not eligible
under this grant. Expenses labeled"other"are subject to approval by the selection committee.
SERVICE COMPONENTS
A. PERSONNEL(DIRECT SERVICES STAFF ONLY) AMOUNT(Use whole dollars only)
Job Title: Program manager $ 57,000.00
Job Title: Outreach assistant—see H2e narrative $23,000.00
Job Title:
Job Title:
A. Subtotal: $ 80,000.00
B. SUPPLIES AND MATERIALS AMOUNT(Use whole dollars only)
Supplies: $ 1,500.00
Duplication: $ 900.00
Materials: Curriculum—for fathers and trainers $ 3,520.00
B. Subtotal: $ 5,920.00
C. COMMUNICATIONS AMOUNT(Use whole dollars only)
Telephone: monthly service$50/month x 18 months $ 900.00
Newsletter design/Digital Video for Community Speaking: $ 1,500.00
Brochures/posters/flyers/development and design cost: $ 4,000.00
Postage: $ 500.00
I C. Subtotal: $ 6,900.00
D. MISCELLANEOUS(no more than 10%of total request) AMOUNT(Use whole dollars only)
Facility&Van Rental: (6 Dad's Club large group activities $ 3,000.00
x $200/ea for facility,$150/ea x 2 vans=$500/activity)
Business Mileage: (7650 miles x .47/mile) $ 3,600.00
Extracurricular books and subscriptions for clients and $ 2,000.00
mentors: ($80.00/volunteer x 25 clients)
I D. Subtotal: $ 8,600.00
E. OTHER AMOUNT(Use whole dollars only)
Specify: On Site Child Care(27 meetings x$40 $ 1,080.00
childcare/mtg)
Specify: Parenting Skills Curriculum Training $ 1,500.00
(3 people x$500/ea)
E. Subtotal: $ 2,580.00
TOTAL(A+B+C+D+E)(Use whole dollars only) $100,000.00
REQUIRED MATCH=(TOTAL x 11.1%):
(Use whole dollars only—round up for match)
MUST BE NON-FEDERAL SOURCES(List sources on
lines below, list amounts in right column.)
Weld County Funds from Dept of Social Services(Awards, $2,100.00 cash
Special Events)
Weld County Funds from Dept of Social Services(Staff $4,265.00 in-kind
time)
Weld County Funds from Dept of Human Services/Family $ 996.00 in-kind case management
Advocate(Intake, Assess, DV Screening, Referral)
UNC- Evaluation(75 hrs x$50/hr) $3,750.00 in-kind
GRAND TOTAL(TOTAL 4- MATCH): $1 1 1,111.00
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H2. SCOPE OF REQUEST-PARENT SKILLS TRAINING(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H2e. Budget Narrative—please describe how the requested funds will be used. Limit response to 50 words in
each category.
Personnel:
The program director's position will be funded to train fathers, and especially to build into the lives of the mentors.
The outreach assistant will provide support only as it directly benefits the fathers, and will have no duties outside of
working with the fatherhood program. As allowed per the grant instructions(pg. 8 section H4),this person will
perform administrative duties, but all duties performed will be direct services to fathers.
Supplies and Materials:
This budget item will provide for curriculum,photocopies,and administrative supplies that are used solely for the
fatherhood program. We will consult with the Promoting Responsible Fatherhood Steering Committee to choose an
evidence based curriculum which focuses on developing parenting skills.
Communications:
Related cell phone expenses, brochure development and printing will be covered by this budget area. Postage and
mailing costs for instructional or promotional purposes will also be covered. Money from this fund will not be used
to purchase cell phones or other equipment.
Miscellaneous:
Business mileage for director and/or mentor training will be provided. Van rental for special activities, such as a
group community outreach project will be covered. Special facilities rental, such as renting out a gymnasium,will
also fall under this category. Provision for continued training is included.
Other:
Child care will be provided as needed for meetings. The budgeted Parenting Skills Curriculum Training amount
allows leaders to attend a training conference/seminar to be determined to help the leader become familiar with and
effectively teach the curriculum.
Match—List source(s):
Weld County Funds from Dept of Social Services(Awards, Special Events) $2,100.00 cash
Weld County Funds from Dept of Social Services(Staff) $4,265.00 in-kind
Weld County Funds from Dept of Human Services/Family Advocate
(Intake, Assess, DV Screening, Referral) $ 996.00 in-kind case mgt
University of Northern Colorado(Evaluation) $3,750.00 in-kind
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112. SCOPE OF REQUEST-PARENT SKILLS TRAINING (CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
1421 Indicate the projected program services statistics for the grant period April 1,2007-September 30,2007.
SERVICE AREA NUMBER SERVED
Total #of Parent Skills Training Sessions Offered: 15 mentor+ 10 client
Total #of Custodial Fathers Served: 14 mentor+ 6 client
Total #of Non-Custodial Fathers Served: I mentor+ 4 client
Total#of Families Served with incomes under$75,000 per year: 15 mentor+ 10 client
Total #of Young Fathers(ages 14-26)Served: 11 mentor+ 10 client
#of Community Education Presentations: 15 mentor+ 12 client
#of Active Volunteers: 20
Other(Please Mentoring sessions 24 sessions per client
indicate): X 12 clients=288 total
Other(Please Life Skills(money mgt, anger mgt,etc) IS mentor+ 10 client
indicate):
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H2. SCOPE OF REQUEST-PARENT SKILLS TRAINING(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H2g. Describe how the proposed services will be monitored.
Persons responsible for service provisions and who supervises them:
The parties involved in executing the Fatherhood program are as follows:
• Mentors-supervised by Fatherhood Program Director
• Administrative Assistant- supervised by Fatherhood Program Director
• Program Director(Mike Bonnell)-supervised by and/or accountable to:
o Summitview Community Church Pastor Perry Paulding
o Summitview Community Church Board
o Department of Social Services
o University of Northern Colorado
o Program reporting to the grantor
• Weld County Department of Human Services(Head Start)- intake,assessment and screening- supervised
by the Director of Human Services
• The University of Northern Colorado-pre and post evaluation-supervised by the Evaluations Director
How will services be monitored? (Include activities involved and frequency. Limit response to 200 words.)
During the monthly class session,all participants will be given a handout with questions geared towards progress of
our stated goals and objectives. The data will be compiled to monitor written progress of all clients and mentors in
the program. The program director will meet with each mentor individually at least once per month to discuss
developments in the client/mentor relationship and provide direction and accountability as needed to make certain
the mentor is maximizing his time and efforts with the client.
The program director will meet quarterly with the board of Summitview Community Church of Greeley. At these
meetings the progress of the program and the use of funds to further the objectives of the program will be discussed
and evaluated.
The program director will also meet in a similar fashion with our collaborative partners, specifically the
Weld County Department of Social Services. These meetings will occur as requested by the Department of Social
Services,with a minimum requirement of meeting semi-annually.
The University of Northern Colorado is also providing pre and post evaluation of the program, providing additional
accountability to the program and to determine overall effectiveness of the program.
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H3a. TOTAL AMOUNT REQUESTED FOR HEALTHY MARRIAGE/COUPLES RELATIONSHIPS
TRAINING:
We are focusing on parenting skills training.
H3b. GOALS AND OBJECTIVES
Goal#1: (Limit response to 50 words.)
We are focusing on parent skills training.
Objectives: (Limit response to 100 words.)
We are focusing on parent skills training.
Goal #2: (Limit response to 50 words.)
I We are focusing on parent skills training.
Objectives: (Limit response to 100 words.)
I We are focusing on parent skills training.
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H3c. What is the applicant's proposed service provision timeline(i.e. what is the sequence of services provided,
are services ongoing or are they offered at specific times of the year)? Please indicate a timeline of services
for each of the months of the contract listed below. Limit responses to 50 words per month.
Quarter#1 April 1, 2007—June 30,2007:
We are focusing on parent skills training.
Quarter#2 July 1,2007-September 30,2007
We are focusing on parent skills training.
Quarter#3 October 1,2007—December 31, 2007
We are focusing on parent skills training.
Quarter#4 January 1,2008—March 3 I,2008
We are focusing on parent skills training.
Quarter#5 April 1, 2008—June 30,2008
We are focusing on parent skills training.
Quarter#6 July I,2008—September 30,2008
We are focusing on parent skills training.
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
(CONTINUED)
H3d. PROPOSED PARENT SKILLS TRAINING BUDGET—DO NOT CHANGE SIZE OR FORMATTING
OF THIS FORM.
Applicants may request funds based on the categories below. Personnel requests must be for direct services staff
ONLY. Direct services staff must provide support and delivery of core services to the target population of this
grant. Staff who provides administrative support are not eligible for funding under this grant. Miscellaneous
expenses must not be more than 10%of total request. Overhead expenses such as rent and utilities are not eligible
under this grant. Expenses labeled"other" are subject to approval by the selection committee.
SERVICE COMPONENTS
A. PERSONNEL(DIRECT SERVICES STAFF ONLY) AMOUNT(Use whole dollars only)
Job Title:
Job Title:
Job Title:
Job Title:
A. Subtotal:
B. SUPPLIES AND MATERIALS AMOUNT(Use whole dollars only)
Supplies:
Duplication:
Materials:
I B. Subtotal:
C. COMMUNICATIONS AMOUNT(Use whole dollars only)
Telephone:
Advertising/News letter:
Brochures:
Postage:
C. Subtotal:
D. MISCELLANEOUS(no more than 10%of total request) AMOUNT(Use whole dollars only)
Facility Rental:
Business Mileage:
Books/Subscriptions for Staff/Volunteers:
D. Subtotal:
E. OTHER AMOUNT(Use whole dollars only)
Specify:
Specify:
Specify:
E. Subtotal:
TOTAL(A+B+C+D+E)(Use whole dollars only)
REQUIRED MATCH=(TOTAL x 11.1%):
(Use whole dollars only- round up for match)
MUST BE NON-FEDERAL SOURCES(List sources on
lines below, list amounts in right column.)
GRAND TOTAL (TOTAL+ MATCH): Not applicable
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H2e. Budget Narrative—please describe how the requested funds will be used. Limit response to 50 words in
each category.
Personnel:
We are focusing on parent skills training.
Supplies and Materials:
We are focusing on parent skills training.
Communications:
We are focusing on parent skills training.
Miscellaneous:
We are focusing on parent skills training.
Other:
I We are focusing on parent skills training.
Match—List source(s):
We are focusing on parent skills training.
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H3f. Indicate the projected program services statistics for the grant period April I,2007—September 30,2007.
SERVICE AREA NUMBER SERVED
Total #of Parent Skills Training Sessions Offered: Not applicable
Total #of Custodial Fathers Served: Not applicable
Total #of Non-Custodial Fathers Served: Not applicable
Total# of Families Served with incomes under$75,000 per year: Not applicable
Total# of Young Fathers(ages 14-26) Served: Not applicable
#of Community Education Presentations: Not applicable
#of Active Volunteers: Not applicable
Other(Please Not applicable
indicate):
Other(Please Not applicable
indicate):
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H3. SCOPE OF REQUEST-HEALTHY MARRIAGE/COUPLES RELATIONSHIPS TRAINING
(CONTINUED)
FOR THE FOLLOWING QUESTIONS, PLACE CURSOR IN BOX AND TYPE ONLY WITHIN BOXES
CONTAINED BELOW. BOXES WILL EXPAND AS INFORMATION IS TYPED. LIMIT RESPONSES AS
INDICATED AND DO NOT EXPAND BEYOND ONE PAGE FOR ALL QUESTIONS ON THIS PAGE.
H3g. Describe how the proposed services will be monitored.
Persons responsible for service provisions and who supervises them:
We are focusing on parent skills training.
How will services be monitored? (Include activities involved and frequency. Limit response to 200 words.)
I We are focusing on parent skills training.
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I. APPLICATION BUDGET
I I. Requested Promoting Responsible Fatherhood Funds(Please list all funds requested by Service
Component. Make sure your amounts are consistent with the amounts on each Service Component's Scope
of Request Page)
SERVICE COMPONENT AMOUNT
Parent Skills Training $100,000.00
Healthy Marriage/Couples Relationship Training $0.00
TOTAL AMOUNT REQUESTED: $100,000.00
12. Matching Funds
Formulas are provided to figure appropriate match based on your total request. Please be sure to list specific sources
of match(United Way, Local Fundraising,etc...),which must be from non-Federal sources. Match sources cannot
be funds already used as matching funds for other federal grants.
Matching Requirements:
(Total Amount Requested)x 11.1%=(Match)
MATCH SOURCES(please list) AMOUNT
Weld County Funds from Dept of Social Services $2,100.00 cash
(Stipends, Awards, Special Events)
Weld County Funds from Dept of Social Services(Staff) $4,254.00 in-kind
Weld County Funds from Dept of Human Services/ $996.00 in-kind case management
Family Advocate(Intake,Assess, DV Screening,
Referral)
University of Northern Colorado(Evaluation) $3,750.00
TOTAL MATCH: $11,100.00
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