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Non-profit Public Service Support Grant Application

  1. Copy of We are open
  2. Overview

    West Norriton Township is offering a total of $100,000 in grants via American Rescue Plan funds to assist local non-profit organizations in providing public services to address adverse impacts of the Coronavirus.

    DEADLINE TO SUBMIT APPLICATION IS October 22nd at 2:00PM.

    Complete each section and attach all required documents to be considered for the West Norriton Non-profit Public Service Support Grant. The platform facilitates secure submission of supporting documentation. 

    Upon successful submission, a confirmation message will be received at top of the page. Users are encouraged to print/save a copy of the application for their records. 

    Due to anticipated response, staff will not provide feedback regarding the status of submissions. Applications will be reviewed in the order received. Contact will be limited to businesses selected to move forward in the process. 

  3. Program Overview

    Eligibility

    • IRS designated 501(c)3 entity.
    • Located within West Norriton Township and in operation as of March 1, 2020.

    Funding

    • Grant funding must be used for the provision of public services including, but not limited to food, housing, homelessness, transportation, and education assistance.
    • Up to 25% of funds may be used for operational costs (payroll, rent, mortgage, utility, COVID mitigation).
    •  Program period/expenditure time-frame is March 1, 2020-September 1, 2021.
    • During the program period, proof of payment must be submitted to document eligible use of grant funds.
    • The recipient will be required to certify that the Township's assistance is not duplicative of any other funding.

    Awards 

    Award amounts will be based on number of eligible applications submitted at conclusion of the application deadline. 

    Recipient Responsibilities 

    • Enter into a formal, written, funding agreement with West Norriton Township.
    • Provide documentation to support expenditure of funds.
    • Make every effort to continue business operations through October 1, 2022.
    • Retain all related records for 3 years after receipt of grant close out letter.
    • If the 501(c)3 closed because of COVID advise the Township of organizations closure by letter from Owner with last day of operation and detailed reason for closure.

    Fraud & Repayment 

    Applicants are advised that making false statements, concealing information, submitting altered documents, utilizing funds for ineligible purposes, or similar actions are considered fraudulent and may result in repayment of the grant award or other legal action. 

    Submission 

    • Applications should only be submitted by the owner, partner, or authorized corporation member. 
    • Applications may only be submitted using the online platform.
    • Applications will be reviewed in the order received.
    • Incomplete applications will not be considered for funding.


  4. AUTHORIZED AGENT SUBMITTING APPLICATION
  5. ORGANIZATION INFORMATION
  6. Business Type*
  7. ADDITIONAL ORGANIZATION INFORMATION
  8. Is business currently closed?*
  9. REQUIRED UPLOADS
  10. OPTIONAL UPLOADS

    Attach payroll, rent, mortgage, utility or COVID mitigation expenses incurred March 3, 2020 through application that West Norriton Township funding will be used for. Be sure that items HAVE NOT and WILL NOT be funded or reimbursed by any other source. 

  11. CERTIFICATIONS & ACKNOWLEDGEMENTS
  12. Certify*

    I certify that this American Rescue Plan assistance is not duplicative of other public or private funding received.

  13. Certify*

    I certify that this American Rescue Plan assistance will be used to provide services which address the adverse impacts of Coronavirus. 

  14. Certify*

    I certify that the organization/agency will make consistent and assertive efforts to continue operations through October 1, 2022.

  15. Certify*

    I certify that I am not aware of any conflicts of interest that exist between the organization/agency, myself, or any person who is an employee, agent, consultant, officer, elected official, or appointed official of West Norriton Township and is in the position to participate in a decision making process or are responsible for the administration or oversight of the Non-profit Public Service Support Grant.

  16. Acknowledgement *

    I acknowledge that, if selected, a formal agreement will be signed with West Norriton Township.

  17. Acknowledgement *

    I acknowledge that, if selected, the program requires that an IRS Form W9 be completed in order to receive payment.

  18. Acknowledgement *

    I understand that making false statements, concealing information, submitting altered documents, utilizing funds for ineligible purposes, or similar actions are considered fraudulent and may result in repayment of the grant award or other legal action. I also understand that failure to submit timely and adequate documentation may result in repayment of funds received.

  19. AUTHORIZED SIGNATURE

    By signing and submitting this document, I certify that I am the sole proprietor, general partner, or member of the aforementioned LLC/corporation. Further, I have made the necessary notifications and received the appropriate authorization to submit an application on behalf of the business/company. I attest that I have thoroughly reviewed the application. The information presented is true and accurate.

  20. Leave This Blank:

  21. This field is not part of the form submission.