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Office of the Chief Technology Officer, Washington, DC, US


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Additional Signatures Required

Application Narrative (10 pages maximum) Click Here to Upload
Program Budget – submitted on the excel template provided Click Here to Upload
Board approved Organization Annual Budget Click Here to Upload
Certifications and Assurances Click Here to Upload
Program Logic Model and/or Theory of Change, any format is acceptable, but template provided for convenience (one page per program maximum) Click Here to Upload
If applicable, citations or bibliography of evidence-based intervention research (one page maximum) (if requesting an award amount of more than $100,000) Click Here to Upload
IRS Determination Letter of 501(c)(3) non-profit organization dated June 7, 2020, or earlier Click Here to Upload
DCRA Basic Business License, currently valid through June 30, 2023, or if it will expire before June 30, 2023, organization will renew the Business License when it expires Click Here to Upload
DCRA Certificate of Good Standing dated within the past year or between June 7, 2021 and June 7, 2022 Click Here to Upload
OTR Clean Hands Certificate dated within the past year or between June 7, 2021 and June 7, 2022 Click Here to Upload
Current fiscal year Income Statement and Profit Loss Statement Click Here to Upload
One (1) year of most recent audit, (financial review if appropriate), or CPA engagement letter Click Here to Upload
Two (2) years of the most recently completed signed Form 990, 990EZ, or 990N and any schedules filed Click Here to Upload
Additional Program Locations (optional). Please be sure to include the full street address, city, state, zip code, and whether or not each location is a DCPS facility or not. Provide a name for each location. Click Here to Upload
Any Additional Attachments, if Necessary Click Here to Upload