Skip to form

DC GOVERNMENT

info@dc.gov

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

SeamlessDocs

The document you are currently trying to view is unavailable

Please contact the form administrator to resolve this issue

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.

x

Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue

x

Additional Signatures Required

Upload Attachment(s)

Please upload the following attachments:

There is a 250MB limit on each attachment.

Experience Questions – Please answer the following questions in three or fewer pages. Provide examples where appropriate. 1. Describe history of working with children and youth. 2. Who are the key people that will deliver the program? If already employed, name them or provide a job description. Describe their experience working with children and youth and why they would be a good fit to be part of the summer camp. Describe how the personnel relate to the target community. 3. How many years has the program been offered and describe past successes and challenges. Describe the impact the program has had on children and youth. Describe the last time programming was offered. 4. Describe how your program recruits and retains participants and why the children and youth remain engaged with the program for the entire summer. 5. Describe resources, facilities, and space requirements the program needs to be successful, such as sink, computer lab, electrical outlets, field space, etc. Click Here to Upload
B. Letters of Support. Provide two letters of support from community members that know the program and work, regardless of where that work has occurred. Click Here to Upload
C. Budget – Provide a budget for programming in any format. Be specific with the Description of Expenses and Calculations. Ensure that all math is accurate. Click Here to Upload
D. Budget Documentation - Used to verify gross revenue under $250,000. Provide one of the following:  Copy of first page of 2020 tax return for individuals and businesses OR  Copy of 2020 (or most recent year filed) IRS Form 990 for non-profit organizations in any form (EZ, postcard, or regular). Click Here to Upload
E. Additional Required Documentation  DC Office of Tax and Revenue (OTR) Clean Hands dated within the past year, or no earlier than April 21 2022. Click Here to Upload