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					              APPLICATION FOR
              EMERGENCY FOOD
             AND SHELTER FUNDS
                        New Hanover County
                         PHASE 27 (2009)




      Please return this COMPLETED application by 5:00pm
                   Tuesday, January 13, 2009 to:

                Emergency Food and Shelter Program
                   New Hanover County Board

by mail:            United Way of the Cape Fear Area
                         Attn: Mallory Thigpen
                     5919 Oleander Drive, Suite 115
                          Wilmington, NC 28403

by hand delivery:   United Way of the Cape Fear Area
                         Attn: Mallory Thigpen
                     5919 Oleander Drive, Suite 115
                         Wilmington, NC 28403
       APPLICATION FOR EMERGENCY FOOD AND SHELTER FUNDS
                        New Hanover County
                                      PHASE XXVII (2009)

EFSP GRANT APPLICATION GUIDELINES:
The Emergency Food and Shelter Program (EFSP) was created in 1983 to supplement and expand
the work of local social service agencies, both nonprofit and governmental, in an effort to help
people with economic (NOT disaster-related [i.e. fire victims, floods, tornadoes, etc.]) emergencies.
 The EFSP funding is open to all organizations helping hungry and homeless people. EFSP funds
MUST BE USED to supplement feeding, sheltering (including transitional sheltering) and
rent/mortgage and utility payment assistance efforts only. EFSP is governed by a National Board
that selects jurisdictions for funding. Local Boards are convened in those qualifying jurisdictions
(New Hanover County) to determine the highest need and best use of funds and to select Local
Recipient Organizations (LROs) that will provide emergency food and shelter services. Each year,
New Hanover County’s needs are to be assessed in an effort to adapt funding allocations to
particular community needs.

EFSP GRANT ALLOCATION INFORMATION:
Adopted Tuesday, November 18, 2008, the New Hanover County EFSP Board adopted the
following application and allocation procedure information for Phase 27 (2009) EFSP Program
funds:

Application Information:
       A legal notice will be published in the Wilmington Star-News to announce the Phase 27
        (2009) EFSP Allocations application, criteria for submission, contact information and
        deadline for submission.
       The Phase 27 (2009) EFSP Allocation application will be distributed VIA E-MAIL to
        CURRENT – Phase 26 (2008) funded programs.
       A completed application (ALL APPLICATION QUESTIONS ANSWERED), including
        required supplemental documents, MUST BE RECEIVED by 5:00pm on TUESDAY,
        JANUARY 13, 2009 at the United Way of the Cape Fear Area: 5919 Oleander Drive, Suite
        115 – Arboretum Center – Building II.

Application Review Process:
       United Way of the Cape Fear Area and the New Hanover County EFSP Board Chair will
        review, after the submission deadline, each application and its accompanying attachments to
        ensure completeness. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
        FOR FUNDING. Applicants will be notified immediately if their applications are
        incomplete.
       United Way of the Cape Fear Area and the New Hanover County EFSP Board Chair will
        then determine whether previously-funded agencies, submitting complete Phase 27 (2009)
        applications, are in compliance with EFSP requirements for allowable activities, use of
        funds, and Generally Accepted Accounting Principles. Any previously-funded EFSP
        agencies NOT IN COMPLIANCE will be brought before the full New Hanover County
        EFSP Board, at the next scheduled meeting, to determine, by majority vote of quorum
        present, whether said agency will be considered for Phase 27 (2009) EFSP Allocations.
       An advertisement will be published in the Wilmington Star-News listing the QUALIFIED
        EFSP Phase 27 (2009) Allocations Applicants to afford public comment and/or concerns on
        respective agencies, for a period of 5 days prior to New Hanover County EFSP Final Phase
        27 (2009) Allocations Meeting.
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       APPLICATION FOR EMERGENCY FOOD AND SHELTER FUNDS
                        New Hanover County
                                       PHASE XXVII (2009)
       Each qualified EFSP Phase 27 (2009) application will be distributed, via e-mail, to a
        randomly selected EFSP Board Member for review, one week prior to the final EFSP Board
        Meeting for Phase 27 (2009) Allocations. United Way of the Cape Fear Area staff will
        assign and distribute qualified applications to an EFSP Board Member, along with any
        received public comments, concerns or non-compliance issues, for review. NO EFSP
        BOARD MEMBERS WILL BE PERMITTED TO REVIEW THEIR OWN AGENCY’S
        APPLICATION. The assigned EFSP Board Member will summarize the agency’s
        application, field questions from the full EFSP Board, and make a recommendation for
        Phase 27 (2009) funding.

EFSP Phase 27 (2009) Funding Allocation Process:
       All EFSP Phase 27 (2009) funding is contingent upon the amount awarded to New Hanover
        County by the National EFSP Board. EFSP fund allocations for New Hanover County are
        determined by the National EFSP Board on a year-to-year basis, with no guarantee of a set
        funding amount.
       Previously-funded EFSP Phase 26 (2008) agencies, in good standing, will receive
        preference in the EFSP Phase 27 (2009) process. New EFSP applicant agencies will be
        considered based on the following criteria, adopted by New Hanover County EFSP Board
        on Tuesday, November 18, 2008: Unique services for the hungry and homeless, and based
        on funding availability. New Hanover County EFSP Board, based on a majority vote of a
        quorum of members present, reserves final determination for funding of any New EFSP
        Phase 27 (2009) Applicants.
       EFSP Phase 27 (2009) funding determinations are based on amounts awarded in EFSP
        Phase 26 (2008) and recommendations for funding from New Hanover County EFSP Board
        members. Each agency’s final allocation for Phase 27 (2009) amounts are awarded by a
        majority vote of a quorum of New Hanover County EFSP Board Members present. New
        Hanover County EFSP Board members MUST ABSTAIN from Phase 27 (2009) allocation
        vote called for their respective agency’s application.

EFSP Phase 27 (2009) FUNDED Agency Information:
       All EFSP Phase 27 (2009) FUNDED Agencies will become default members of the overall
        New Hanover County EFSP Local Board.
       New Hanover County EFSP Local Board Meetings are held quarterly, usually on a Tuesday,
        from 10:00am-12:00noon at 613 Shipyard Blvd. – formerly the United Way of the Cape
        Fear Area – NOW Coastal Horizons Center Conference Room.
       All EFSP Phase 27 (2009) FUNDED Agencies are REQUIRED to send a representative to
        at least three (3) of the four (4) quarterly meetings. If an EFSP Phase 27 (2009) agency
        does not attend a scheduled quarterly board meeting, they will be contacted by a United
        Way of the Cape Fear Area staff to be alerted their agency’s absence has been noted. An
        EFSP Phase 27 (2009) FUNDED Agency that FAILS to attend three (3) out of four (4)
        quarterly meetings WILL BE TREATED AS A NEW EFSP AGENCY APPLICANT IN
        THE FOLLOWING PHASE’S FUNDING PROCESS.




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        APPLICATION FOR EMERGENCY FOOD AND SHELTER FUNDS
                         New Hanover County
                                                 PHASE XXVII (2009)
GENERAL INFORMATION

Name of Organization: ________________________________________________

Agency’s Physical Address:                _____________________________________

                                          _____________________________________

Agency’s Mailing Address:                 _____________________________________
                                          _____________________________________

Phone Number : ______________________________________

Taxpayer I.D.# : ______________________________________

Executive Director:                ______________________           ______________________________
                                   NAME                             SIGNATURE

Phone Number: ___________________________ Email Address: ___________________________________

Board President:                   ______________________           ______________________________
                                   NAME                             SIGNATURE

Phone Number: ___________________________ Email Address: ___________________________________


Approved by Board on:                  ________________________________ (date)

Contact Person:                           ___________________________________
If different than Executive Director      NAME

Phone Number: __________________________ Email Address: ___________________________________



Requested EFSP GRANT Amount: $______________________


 Attachments:

 A.    IRS Letter of tax-exempt 501(c)(3) Status (or other exempt status)
 B.    Current List of Volunteer Board Officers & Directors
 C.    Copy of Current Approved Audit (may be returned if requested)
 D.    Most recent Financial Statement (board approved)




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                APPLICATION FOR EMERGENCY FOOD AND SHELTER FUNDS
                                 New Hanover County
                                                    PHASE XXVII (2009)
        AGENCY ELIGIBILITY

        1.       Is the agency a nonprofit or an agency of government?

        2.       Does the agency have an accounting system? ________ YES ________ NO
                 If yes, what accounting software does your agency utilize?

        3.       Describe target populations that will be served by this FEMA EFSP grant?

        4.       What is the eligibility criteria for serving a client?

        5.       What is your geographic service area? Describe how your agency will assure these FEMA
                 ESFP funds will be utilized in New Hanover County:

        6.       Does the agency practice nondiscrimination? __________ YES __________ NO
                 If yes, does your agency have a Board-approved, written Non-Discrimination Policy?

        7.       Is your agency a faith-based organization? ________YES ________NO
                 If yes, does your agency agree not to refuse services to an applicant based on religion or
                 require attendance at religious services as a condition of assistance, nor will such groups
                 engage in any religious proselytizing in any program receiving Emergency Food and Shelter
                 Program fund.

        APPLICANT AGENCY INFORMATION

        1.       Describe the organization's mission and purpose; include information on current programs
                 and services.

        2.       If awarded, explain exactly how the organization will use EFSP funds in 2009. Describe
                 in detail, including target population and number of people to be served.

        REQUEST WORKSHEET
Instructions:    Agencies that received EFSP funds in 2008 (Phase 26), please answer all questions. Agencies that
                 did not request or receive funds in 2008, please answer questions 3 and 5.

        1.     If you received EFSP funds for 2008 (Phase 26), what dollar amount did your agency actually
        receive in each category? Please include units of service.

        Expenditure Category                Amount            Est. % of         Units of Service   # People Served
                                                              Total Budget
        Served meals                        __________        _________         ______ meals       __________
        Other food                          __________        _________         ______ meals       __________
        Mass shelter                        ____________      _________         ______ nights      __________
        Other shelter                       __________        _________         ______ nights      __________
        Rent/Mortgage payments              __________        _________         ______ bills       _________


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             APPLICATION FOR EMERGENCY FOOD AND SHELTER FUNDS
                              New Hanover County
                                                  PHASE XXVII (2009)
       Expenditure Category                  Amount    Est. % of    Units of Service                             # People Served
                                                       Total Budget
       (Continued)
       Utility payments                      __________          _________          ______ bills                 __________
       Supplies/Equipment                    __________          _________          ______                       __________
       Emergency Repairs                     __________          _________          ______                       __________
       Administration                        __________          _________          ______                       __________

       2.     If your agency returned any awarded EFSP funds in Phase 26 (2008) or Phase 25 (2007) by
       writing a check to United Way of America, please put the dollar amount here and the reason why
       you returned the funds.

       2008 amount returned: $__________________
       Reason:_______________________________________________________________________________
       _____________________________________________________________________________________
       _____________________________________________________________________________________

       2007 amount returned: $ __________________
       Reason:_______________________________________________________________________________
       _____________________________________________________________________________________
       _____________________________________________________________________________________

       3.        What is your request for EFSP funds for Phase 27 (2009)
       (Notes: In the Mass shelter category, $7.50 or 12.50 per diem. In the Served Meals category, you may elect to use $2.00 as per Diem.)

**NOTE: On 9/16/08-EFSP Local Board approved a $12.50 per diem amount for Mass Shelter documentation.

       Expenditure Category                  Amount              Est. % of          Units of Service             Anticipated #
                                                                 Total Budget                                    People Served
       Served meals                          __________          _________          ______ meals                 __________
       Other food                            __________          _________          ______ meals                 __________
       Mass shelter                          __________          _________          ______ nights                __________
       Other shelter                         __________          _________          ______ nights                __________
       Rent/Mortgage payments                __________          _________          ______ bills                 __________
       Utility payments                      __________          _________          ______ bills                 __________

       4.    If you are requesting an amount that is greater than the amount you received last year, how
       many additional units of service will you be able to provide?

       Served meals:                         ______ meals                  Other shelter:                        ______ nights
       Other food:                           ______ meals                  Rent/mortgage payments:               ______ bills
       Mass shelter:                         ______ nights                 Utility payments:                     ______ bills

       5.       Comments (This space is provided for any additional information you may wish to include.
                Please keep to fifty words or less. (Optional):



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