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HomeMy WebLinkAboutExhibit ACity of Miami Anti -Poverty Initiative Program Funding Request Form CONTACT INFORMATION: Contact Person: Craig E. McQueen Title: Chairman/ President Phone number: 305-986-8910 Email Address: cemcqueen@bellsouth.net r. L' Ad n,,��., Name of Person completing this form: `1ra 9 • 1`1`'`1u��1` Legal Name of Organization: Greater Miami & South Florida Youth and Community Inc. Address (Street, City, State, Zip Code): 3581 S.W. 68th Terr. Miramar, F1. 33023 Executive Director of Organization: Executive Director email: Executive Director Contact Phone Number: The organization is a registered and active State of Florida Corporation (select one): ❑ For-profit organization rn J✓ J Not -for profit organization 1501(3)(c)) ❑ Local governmental unit ❑ State governmental unit r__1 Educational and academic institution ❑ City of Miami department, agency and board Page 1 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form ORGANIZATION AND PROGRAM/PROJECT INFORMATION Organization History and Background Information: Greater Miami & South Florida Youth & Community Inc. (GMSFYC) was founded by three City of Miami Police Officers on April 01, 2013. GMSFYC was created and designed to be a crime free, crime prevention, safe enviroment organization using academics and sports programs to serve the youth in the City of Miami and build a strong relationship between the police and the community. GMSFYC mission statement is simple and pure "Officers Making a Difference" Is your program/project providing direct services to residents of the City of Miami? YesONo❑ Number of residents your entity will serve: 260 Frequency of Service: annual -year round Age Group Served: 5 to 15 Is your program/project impacting one of Miami's disadvantaged communities? Yes ❑✓ No Geographic Area Served (specific to this project/program) District Served (1, 2, 3, 4, S, Citywide) 5 Neighborhood/Community being served: Allapattah,wynwood,Overtown Program/Project Priority area (Select one): W✓ Educational Programs for children, youth and adults Crime Prevention Elderly meals, transportation, recreational and health/wellness related activities At -risk youth or youth summer job programs Transportation services and programs Job development, retention and training programs Homeless Services Page 2 of S Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program - Funding Request Form Program/Project Title: GMSFYC- Miami Youth Academics and Sports programs Project/Program Description: GMSFYC- Miami Youth Hurricanes Academics and Sports programs includes; Youth Mentoring, Healthy Eating Camps, Flag & Tackle Football, Cheerleading, Dance Troops, Track & Field, Drumline, Self -Defense and Crime Prevention Martial Arts. .?anuary 01, 2019 IJcce,ny_r3i.,nin =ncc Program Start Date: Program End Date: - Please describe how this program/project and funding will alleviate poverty within the City of Miami? By exposing the City of Miami youth to postive alternatives, instead of making bad choices that can lead to criminal activity and school drop-out. GMSFYC currently partners with local businesses and educational enitites as resources of opportunities for our particpants and their parents. IMPACT AND PERFORMANCE: Describe overall expected outcomes and performance measures for this project/program: rr rr�rr 4_A 4�._.__� r ._ �..._ 4t a _ r . _ involved IDMS r C - expectcu ouLCuiiic lu our programs is the reduction of youth involved crimes, reduction of school drop -outs, increase college attendance for children in our programs and better relationship between participants and the police department. Please attach additional pages to the back of this packet, if the space above is not sufficient. Page 3 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program - Funding Request Form FUNDING REQUEST INFORMATION.- Amount NFORMATION. Amount Requested: $ 10,000.00 Explain how the City of Miami Anti. -Poverty funding will be utilized: Funding will be used to keep our program registration cost free or low cost by covering registration fees, transportation cost equipment purchases, Itemize API funding related to expenditures below: Personnel Salaries & Wages: Personnel Benefits Space Rental: Utilities (Electricity, Phone, Internet): Supplies: Marketing: Transportation (Participants): Meals (Participants): $ 0 $ 0 $ $1200 $ $600. $ $3,000 Professional Services (List each): Other (please describe): Pop Warner Insurance $3,OOC Other (please describe): Pop Warner League Fee $1,20C Other (please describe): Criminal History check $1,000 Page 4 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form To be completed by the Entity/Recipient By signing below you agree to the guidelines and stipulate that the information provid don this form is accurate and complete. . Craig E. McQueen j ,�,r�Q�, _ Completed by (Print &Sign). Date: 10/22/2019 Additlonal Comments: All fuud.ing received goes directly toward program needs. GMSFYI has no paid employees. GMSFYC-volunteers give on an average of 1000 volunteer hours to our particpants. To be completed by District Commissioner/ Mayor's Office Recommended for funding: Yes�NofI Funding Recommendation: 10&0Q Commission Meeting Date: 1l Z1 ! Additional Comments: Completed by (Print & Sign):' Date: !! io p301 t� ✓ To be completed by the Department Received by (Print & Sign).r'4 /,4z --:5:5A4 Date: - Additional Comments: i Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 Page 5 of 5