EFSP Application | United Way of Acadiana

EFSP Phase 41 Application

Deadline for applications to be received: March 29, 2024 at 11:59 by form submission. Questions regarding application requirements may be directed to Hunter Leedy at (337) 233-8302.

Parish(Required)

Organization Mission Statement(Required)

Describe the population your agency serves as well as how you hope to utilize the funding requested.

The following information will provide the Local Board with the information necessary to make the best funding decisions possible.

Agency Legal Name(Required)

Agency Principal Contact(Required)

Name Email Phone

Agency Contact for Application Questions and Funding Information(Required)

Name Email Phone

Agency Physical Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Congressional District where agency is physically located:(Required)

Agency Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Agency Address for Place of Performance (where the EFSP funded services are provided)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Congressional district where agency's EFSP funded services are provided (Place of Performance):(Required)

Agency Website(Required)

Agency Federal Employer Identification Number (FEIN):(Required)

Amount of EFSP Funding Requested by Program Area(Required)

Total for Selected Program Area(Required)

Amount of EFSP Funding Requested by Program Area

Total for Selected Program Area

Amount of EFSP Funding Requested by Program Area

Total for Selected Program Area

Agency Operating Budget (Total):(Required)

Provide a brief description of the program that EFSP Funds will support.

Number of clients expected to serve with requested funding (separated by category):(Required)

Is your agency non-profit or a unit of government?(Required)

non-profit

unit of government

Is your agency debarred or suspended from receiving funds or doing business with the Federal government?(Required)

Yes

Do you have any outstanding EFSP funds?(Required)

Yes

Do you have any outstanding compliance issues?(Required)

Yes

Please list any previous compliance issues EFSP has flagged your organization for. List year, phase, and compliance issue.(Required)

Please enter N/A if not applicable.

Please list any requests for funds to be transferred from one category to another.(Required)

Please enter N/A if not applicable.

Upload Important Documents (PLEASE ATTACH: Agency budget for the program area requested, copy of agency’s most recent annual audit, and if your agency is a non-profit, please provide a roster of the agency’s volunteer board.)(Required)

Drop files here or

Max. file size: 128 MB.

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337-233-8302

EFSP Phase 41 Application

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