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# Senior Corps **GRANT APPLICATION Volume II**  **Foster Grandparent Program (FGP) Senior Companion Program (SCP)** 

for **Competitiv e**  **Applications Non**  **- Competitiv** **e Renew als**  **Continuation A pplications** 

**DRA FT FA** **CSIMILE OF ELECTRONIC FORMS** Form is Authorized for Local Reproduction **CNCS Form 424 -**  **NSSC OM**  **B Control No. 3045 -**  **0035 -**  **Expiration: 06/30/2014** 

### OMB Control No. 3045 - 0035 - Expires 06/30/2014

2 

## T **ABLE OF** 

## C **ONTENTS INSTRUCTIONS**  I. Purpose
................................ ................................ ................................ ................................ ...................... 3 I I: Required Sections
................................ ................................ ................................ ................................ ..... 4 Part I: Facesheet Instructions (eGrants “Applicant”, “Application”, and “Funding Demographics” Sections)
.... 5 Part I I: Project Narratives Instructions (eGrants “Narratives” Sections)
................................ ......................... 9 Part II Section A: Executive Summary
................................ ................................ ............................ 9 Part II Section B: Strengtheni ng Communities
. ................................ ................................ .............. 1 0 Part II Section C: Recruitment and Development of Volunteers
................................ ...................... 1 3 Part II Section D: Program Management
................................ ................................ ...................... 1 2 Part II Section E: Organizational Capacity
................................ ................................ ..................... 1 3 Part II Section F: Other NOFA Requirements
................................ ................................ ................ 1 3 Part III : Performance Measures and Wo rkPlans (eGrants “Wo rkPlan” Sections)
............ . ...... . ......... .. ....1 5 Part III Section A: About Performance Measures Requirements
................................ ..................... 1 5 Part III Section B: About W ork Plans
................................ ................................ ............................. 1 6 Part IV: Required Documents
................................ ................................ ................................ ................... 23 Part V : Budget Instructions (eGrants “Budget” Sections)
................................ ................................ ............ 2 4 Part V Section A: Volunteer Support Expenses
................................ ................................ ............. 2 4 Part V Section B: Volunteer Expenses
................................ ................................ ......................... 2 6 Part VI. Funding/Demographics (eGrants “Estimated Funding” Sections)
................................ ......................... 2 7 Continuous Application Instructions.....
............................... ........................................................ ....................2 8 **FORMS:** Part I
– Facesheet
................................ ................................ ................................ ................................ ... 2 9 Roster of Active Volunteer Stations (Form and Instructions)
................................ ................................ ....... 30
**AP PENDICES:**  eGrants Step - by- Step Instructions
................................ ................................ ................................ ............. 15 eGrants Performance Measures Module (PMM) Step - by- Step Instructions
................................ ............. 16 - 17 Wo rk Plan Development W orksheets
................................ ................................ ................................ ........ 18 List of Service Activities and Instruments/Tools
................................ ................................ .......................... 21

### OMB Control No. 3045 - 0035 - Expires 06/30/2014

3 **SENIOR CORPS GRA NT**  **AP PLICA**  **TION: GENERA**  **L SUBMISSION INSTRUCTIONS 1**  **(I) Purpose:**  The Senior Corps Grant Application of the Corporation for National and Community Service (CNCS) is for use by prospective and existing sponsors of Senior Corps projects under the RSVP Program (RSVP), Foster Grandparent Program (FGP) Senior Companion Progra m (SCP), and Senior Demonstration Programs (SDP). The forms in this package conform to CNCS ’s web - based electronic grants management system, eGrants. If needed, please refer to **eGrants step -**  **by -** **step instructions** as you complete the grant application, loca ted here: LINK
. TIP for new applicants in particular: You are encouraged to review and reference these instructions as you read these Grant Application Instructions and use eGrants. The Senior Corps Grant Application Consists of two volumes: 1) Volume I
– Used by applicants for RSVP grants. Instructions within the grant application indicate which sections are required for: (A)
– Competitive Grant Application Submissions (B)
– Non - Competitive Administrative Renewals (only as applicable). (C)
– Continuation Grant Application Submissions (current grantees only, for second or third years of a three - year grant). 2) Volume II
– Used by applicants for Foster Grandparent and Senior Companion grants, including competitive grants, renewal (non - competitive grants), and contin uation grants (current grantees in the second or third years of a three year grant). Instructions in this package apply to all applicants. The instructions address the types of information that must be included to fulfill application and grant requiremen ts. New applicants must establish an eGrants account by accessing this link: https://egrants.cns.gov/espan/main/login.jsp and selecting: “Don’t have an eGrants account? Create an account.” **For A pplicants submitting Competitive Grants:**  Please use these Grant Application Instructions in 

### conjunction with the Notice of Federal Funding Opportunity (Notice) and RSVP Program Regulations [45 CFR Part 2553]. 

### The Notice includes deadlines, eligibility requirem ents, subm ission requirements, review criteria and other information applicable to RSVP grant com petitions . The NOFO is located here: INSERT **For non -**  **competitive grants** , the CNCS office in each state will provide notification instructions, includi ng when to begin your next grant application in eGrants
.

1 OMB No. 3045 - 0035. The collection of this information is authorized by the provisions of the Domestic Volunteer Service Act of 1973, as a mended, and the National and Community Service Trust Act of 1993. This agency informs the potential persons who may respond to the collection of information that such persons are not required to respond to this collection of information unless it displays a currently valid OMB cont rol number. Estimated time to complete this application, including time for reviewing ins tructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information averages 13.2 hours per response (16.5 for new applicants, 15 for prev ious sponsors, and 5 for revisions). If you have any comments regarding this collection of information, send them to: Corporation for National and Community Service, Sen ior Corps, Attn: Angela Roberts, 1201 New York Avenue, W, Washington, D.C. 20525. As required by Section 504 of the Rehabilitatio n Act of 1973, as amended, this application may be available in alternative formats. Make **TTD/TTY** inquiries to: (202) 565 - 2799. Direct written inquiries to: Senior Corps, 1201 New York Ave. N W, 9 th Floor, W ashington, DC 20525. Direct telephone inquirie s to: (202) 606 - 5000, Ext. 554.

### OMB Control No. 3045 - 0035 - Expires 06/30/2014

4 **Prohibited A ctivities**  For FGP and SCP competitive applications, please refer to the Notice
. For FGP continuation grants, please refer to the FGP Regulations link. For SCP continuation grants, please refer to the SCP Regulations link.
**(II) Required Sections of the Grant A**  **pplication (a)**  **First -** **time A pplicants for an RSVP, Foster Grandparent, or Senior Companion Grant that are**  **apply ing for a**  **competitive grant or current Foster Grandparent or Senior Companion grantees apply**  **ing for a new multi -** **year renewal g rant must complete all sections of**  **the Grant Ap**  **plication:**


###  Part I: Facesheet (Modified Standard Form 424 NSSC)
– Page 15 

###  Part II: Budget (NSSC Form 424A)
– Pages 16 - 17 

###  Part III: Project Narratives
– Page 

###  Part IV: Wo rk Plans
– Pages 9 - 10 

###  Attachments: Required attachments are indicate d on Page 14 

###  Assurances (Standard Form 424B)
– Page 21 

###  Certifications (NSSC Form 424C)
– Page 22 **(b) Non**  **- Competitive Continuation A**  **pplications: Years 2 and 3 of the Multi -** **Year Grant must complete the following sections:**  

###  Part I: Facesheet (Modified Standard Form 424 NSSC)
– Page 15 

###  Part II: Budget (NSSC Form 424A)
– Page 16 - 17 

###  Part III - Section ___: Executive Summary
– Page and amend any existing information if not relevant or current for the upcoming grant performance period. 

###  Part IV: W ork Plans
– Update work plans that have changed from initial submission so to remain consistent with the proposed activities and performance measures. 

###  Attachments: As specified for continuation projects on Page 14 

###  Other: Updates of any other sect ions of the application or the required attachments if significant changes have occurred or are anticipated during Year 2 or Year 3.

1 OMB No. 3045 - 0035. The collection of this information is authorized by the provisions of the Domestic Volunteer Service Act of 1973, as amended, and the National and Community Service Trust Act of 1993. This agency informs the potential persons who may respond to the c ollection of information that such persons are not required to respond to this collection of info rmation unless it displays a currently valid OMB control number. Estimated time to complete this application, including time for reviewing instructions, searching existing data sources, gathering and maintain ing data needed, and completing and reviewing t he collection of information averages 13.2 hours per response (16.5 for new applicants, 15 for previous sponsors, and 5 for revisions). If you have any comments regarding this collection of information, send them to: Corporation for National and Co mmunity Service, Senior Corps, Attn: Angela Roberts, 1201 New York Avenue, W, Washington, D.C. 20525. As required by Section 504 of the Rehabilitation Act of 1973, as amended, this application may be available in alternative formats. Make **TTD/TTY** inquiries to: (202) 565 - 2799. Direct written inquiries to: Senior Corps, 1201 New York Ave. N W, 9 th Floor, W ashington, DC 20525. Direct telephone inquiries to: (202) 606 - 5000, Ext. 554. **N ote:**  Submission of a grant application does not assure receipt of a grant award.

### 5 **PA RT I: FA** **CESHEET INSTRUCTION S: eGrants “A** **pplicant”, “A** **pplication” , and “Funding** 

**Demographics” Sections** 

**Must Be Completed by AL**  **L Ap**  **plicants for Competitive Grants Must Be Updated for A** **ccuracy by**  **all Grantees entering Continuation Years**  

### Information entered in the Applicant Info, Application Info, and Budget sections will populate the SF 424 Facesheet in the eGrants system
. The items below coincide to sections of the SF 424 Facesheet. Please enter or update the reques ted inform ation in the fields that appear. The contact person needs to be the person who can answer questions about the application. **Item #** 1. Filled in for your convenience. 2. Self- explanatory. 3. 3.a. and 3.b. are for State use only (if applicable). 4. Item 4.a: Leave blank Item 4.b: If you are a current grantee applying for year 2 or 3 of an already- awarded grant, enter the grant number. Otherwise, leave blank. 5. This section contains the Applicant Information. Please e nter the following information: a. The c omplete name of the organization that will be legally responsible for the grant. This is **not** the name of the organizational unit within the legally responsible organization. For example, indicate “National University” instead of “Liberal Arts Department.” b. The name of the primary organizational unit that will undertake the assistance activity, if different from 5.a. Using the example above, here is the place to use “Liberal Arts Department.” c. Your organization’s complete address with the 5 - digit ZIP code and the 4 - digit extension. The 4 - digit ZIP code extension is required. d. The name and contact information of the project director or other person to contact on matters related to this application. 6. Enter your Employer Identification Number (EIN) as assigned by the Internal Revenue Service. 6a. Enter your Organization’s Dun and Bradstreet Data Universal Numbering System (DUNS) number. If needed, the applicant organization may obtain a DUNS number by calling the request line at (866) 705 - 5711 or online at **http://www.dnb.com .**  7. Item 7.a.: Enter the appropriate letter in the box. Item 7.b: Consult the following list of characteristics of applicants and enter (all that apply) the corresponding numbers, each in a separate blank.

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1. 2 - year college 17. Local Government Municipal 

### 2. 4 year college 18. National Non - profit (Multistate) 

### 3. Area Agency on Aging 19. Other Native American Organization 

### 4. Chamber of Commerce/Business Association 20. Other State Government 

### 5. Community Action Agency/ Community Action Program 21.School (K- 12) 

### 6. Community College 22. Self- Incorporated Senior Corps Project 

### 7. Community- Based Organization 23. Service/Civic Organization 

### 8. Faith - based organization 24. State Commission/Alternative Administrative Entity 

### 9. Governor’s Office 25. State Education Agency 

### 10. Grant - making Entity Operating in Two or More States 26. Statewide Association 

### 11. Health Department 27. Tribal Government Entity 

### 12. Hispanic Serving College or University 28. Tribal Organization (non government) 

### 13. Historically Black College or University (HBCU) 29. U.S. Territory 

### 14. Law Enforcement Agency 30. Vocational/Technical College 

### 15. Local Affiliate of National Organization 31. Volunteer Management Organization 

### 16. Local Education Ag ency 8. Check the appropriate box for type of application and enter the appropriate letter(s) in the lower boxes: a. Check “New” if you are applying for a new competitive FGP, SCP, or SDP grant
. b. Check “Continuation” if you are a current grantee applying for your second or third year of funding. c. Check “ Amendment ” if you are a grantee proposing any change in your budget, requesting a no cost extension, or revising your W ork Plans. If you are proposing an Amendment to your grant, check the type of revision yo u are submitting. a. Select “ Budget Revision ” if you are a Senior Corps FGP, SCP, or SDP grantee submitting a revised budget to incorporate a Corporation - authorized increase. b. Select “ Budget Revision ” if you are a Senior Corps FGP, SCP, or SDP grantee submitti ng a revised budget to incorporate a Corporation - authorized decrease. c. Select “ No Cost Extension ” to request an extension of the grant period, then enter the extension date requested in the blank following the checkbox. No - cost extensions must be requested before the project period ends. d. Select “Augmentation” if you are taking an action that changes the programming of the awarded grant. e. Select “Other,” as applicable, and specify in the blank provided. 9. Filled in for your convenience. 10. Use the following list of CFDA (Catalog of Federal Domestic Assistance) number fo r FGP, SCP, or SDP : 94.00 Foster Grandparent Program (FGP) 94.00 Senior Companion Program (SCP) 94.00 Senior Demonstration Program (SDP) 11. Select the appropriate link or dropdown project to : a. Enter the title of the project. (For example, SCP of Cabot County , FGP of Cabot County )

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b. Enter the name of the CNCS program initiative, if any, as provided in the instructions corresponding to the NOFA for which you are applying; otherwise, lease blank. 12. List all of the geographic locations where the service will occur or is occurring. Please designate by the county or counties. Please include all counties applicable. For **competitive grants** , please also include the appropriate state and number of the gra nt opportunity from the Notice (for example: North Carolina #3). 13. Please reference Item 8 (Above) 

###  “New: Enter the proposed project Start and End Dates. This is a 3 - year period , also known as the “project period.” 

###  “Continuation” or “ Amendment” application: Enter the dates of the approved project period. 14. Fill in the performance period. The “performance period” is the duration covered by the budget, and is usually defined as 12 - months. If other than 12 - months, the Notice or supplemental guidance will indicate the performance period. 15. Estimated Funding: Enter the amount requested or to be contributed **during this performance period** on the appropriate line, as shown below. The value of in - kind contributions should be included in these amounts, as applicable. For revisions (See item 8), if the action will result in a dollar change to an existing award, include only the amount of the change. For decreases, enclose the amounts in parentheses. (a) **Federal** The total amount of Federal funds being requested in the budget. This amount is automatically populated based on budget sections I and II. (b) **Ap plicant**  The total amount of the app licant share as entered in the budget. This amount is automatically populated based on budget sections I and II. (c) **Local** The amount of the applicant share that is coming from local sources. (d) **State** The amount of the applicant share that is coming from state sources. (e) **Other** The amount of the applicant share that is coming from other sources. (f) **Income** The amount of the applicant share that is coming from income generated by programmatic activities. (g) **Total** The applicant's estimate of the total funding amount for the agreement . This amount is automatically populated based on budget sections I and II. 16. Indicate if this application is subject to review by the state "Executive Order 12372 Process" by checking the box. Executive Order 12372, "Intergovernmental Review of Federal Programs," was issued with the desire to foster the intergovernmental partnership and strengthen federalism by relying on state and local processes for the coordination and review of proposed federal financial assistance and direct Federal develop ment. The Order allows each state to designate an entity to perform this function. A list of these "Single Point of Contact" entities can be found at: 

### http://www.whitehouse.gov/omb/grants_spoc
. Contact the Single Point of Contact to determine whether your application is subject to the state intergovernmental review process. a. If Yes, indicate the date a copy of your application was submitted to the state for review under the Executive Order 12372 Process b. If No, check the appropriate box. 17. Check the appropriate box. This question applies to the applicant organization, not the person who signs as the authorized representative. Categories of debt include delinquent audit allowances, loans, and taxes. If Yes, attach an explanation. 18. Signature. Please note that this is an electronic signature that results from submitting the grant application in the electronic grants management system, eGrants. The person who signs this form must be the

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applicant’s auth orized representative. A copy of the governing body’s authorization for this official representative to sign must be on file in the applicant’s office. **Note:** Falsification or concealment of a material fact, or submission of false, fictitious or fraudule nt statements or representations to any department or agency of the United States Government may result in a fine of not more than $10,000 or imprisonment for not more than five (5) years, or both. (18 U.S. Code Section 1001)

### 9 **PA RT**  **II: PROJECT NARRA**  **TIVES INSTRUCTIONS (eGrants “Narratives” Sections)** The purpose of the program narratives and the accompanying Wo rk Plans (see Part IV) is for you to provide a project plan with a clear and compelling justification for achieving results with the requ ested funds. You **may**

**not exceed 2 5**  **double -** **spaced pages for the Narratives, including the Executive Summary** as the pages print out from eGrants. In the case of **competitive grants** , **reviewers will not consider** material submitted over the page limit, even if eGrants allows you to enter and submit text over the limit. From the Review and Submit page, print out your application prior to final submission to ensure it is not over the 2 5 page limit . This limit does n ot include the budget and performance measures. **PA RT**  **II –**  **SECTION A . EXECUTIVE SUMMA**  **RY Must be completed by**  **all applicants: Competitive A pplicants and Continuation Grantees**  Please provide a summary of your proposed or ongoing project. The Executive Summary must be no longer than one page. The summary should include:
 The number of unduplicated Foster Grandparent or Senior Companion volunteers serving or that will serve.  The types of populations they serve or will serve, such as childre n, frail seniors, veterans, etc.
 The primary focus area that the project will address.
 The volunteer service activities or what they actually do or will they actually do.
 The locations of these service activities.
 The expected results or outcomes of the volunteers’ services.
 The number of stations
 The federal funding level
 The non -federal funding level You may adopt and fill in the blanks on the following template to complete your Executive Summary: “An estimated [**fill in the number**] FGP or SCP volunteers will serve. They will [**fill in service activities** ] through a network of [**fill in the number of volunteer stations/placement sites** ] such as [**fill in ty pes of**  **organizations where the volunteers serve or will serve** ]. The primary focus area of this project is [**fill in CNCS Focus A**  **rea** ]. At the end of the 12 - month performance period, [**fill in the anticipated outcome(s** )]. The CNCS federal investment of $ [**fill in the annual federal grant amount or the requested amount**] will be supplemented by $ [**fill in the antic ipated level of non**  **- federal resources**  ]. **NOTE:** CNCS will post these summaries on www.nationalservice.gov in the interest of t ransparency and Open Government.

### 10 **PA RT**  **II –**  **SECTION B. STR ENGTHENING COMMUNITIES**  **Must Be Completed by AL**  **L Ap**  **plicants for Renewal Grants Must Be Updated for A** **ccuracy by**  **all Grantees entering Continuation Years Guideline for Writing Your Narratives**  As you write your grant application narratives, which are found in **Part III –**  **Sections B through E**  of this application, unless otherwise noted, please focus your descriptions on how you will achieve will achieve outcomes. Below, please find the Performance Measure Requirements for each program
– FGP and SCP. The recommended number of pages fo r this section is: ______ Grants must align with the **FGP or SCP Performance Measures Requirements**  , respectively. These requirements are listed below, and are repeated in Part IV
– Wo rk Plans. **FGP A pplicants:**  See Part IV(a) **SCP A pplicants:**  See Part IV(b) **1) Performance Measures Requirements**  Your grant application must reflect the Performance Measures Requirements established for the Foster Grandparent Program and Senior Companion Program, respectively, as noted below. The performance measures are documented as a required part of the work plans submitted as part of your grant application. The unit of measure for Foster Grandparent and Senior Companion Program performance measures requirements is “unduplicated volunteers.” “Unduplicated volunteers” means that each FGP or SCP volunteer is only counted once, even if the volunteer is engaged in more than one activity. Please review the Performance Measures Requirements for the Foster Grandparent Program and Senior Companion Program on the following pages prior t o writing your grant application narratives.**Foster Grandparent Program Performance Measures Requirements**

Your grant application must reflect the Performance Measures Requirements established for the Foster Grandparent Program, as listed in items A) an documented as a required part of the work plans submitted as part of your grant application. **A) Requirement 1:**  At least 75 percent of the unduplicated Foster Grandparent volunteers must be in work plans address Agency Readiness
. **B) Requirement 2:**  No more than 25 can be placed in assignments that address:  Agency -Wi de Outputs in K  Complementary Measures Outputs in Child Safety, W elfare, and Health; Education; Economic Opportunity.



### 11 **Foster Grandparent Program Performance Measures Requirements** Your grant application must reflect the Performance Measures Requirements established for the Foster Grandparent Program, as listed in items A) an d B) below. The performance measures are documented as a required part of the work plans submitted as part of your grant application.

At least 75 percent of the unduplicated Foster Grandparent volunteers must be

-Wi de Priority Measure Outcomes for K - 12 Success and/or School No more than 25 percent of the unduplicated Foster Grandparent v can be placed in assignments that address:

Wi de Outputs in K - 12 Success and/or School Readiness and/or Complementary Measures Outputs in Child Safety, W elfare, and Health; Education; **Foster Grandparent Program Performance Measures Requirements** Your grant application must reflect the Performance Measures Requirements established for the d B) below. The performance measures are documented as a required part of the work plans submitted as part of your grant application.

At least 75 percent of the unduplicated Foster Grandparent volunteers must be 12 Success and/or School Foster Grandparent v olunteers Readiness and/or Complementary Measures Outputs in Child Safety, W elfare, and Health; Education;**Senior Companion Program Performance Measures Requirements**

Your grant application must reflect the Performance Measures Senior Companion Program, as listed in items A) and B) below. The performance measures are documented as a required part of the work plans submitted as part of your grant application. **A) Requirement 1:**  At least 90 percent of the unduplicated Senior Companion volunteers must be in work plans address Agency Outcome and/or Complementary Program Measures **B) Requirement 2:**  No more than 10 percent of the unduplicated Senior Companion volunteers can be placed in assignments that address the Assisted Living Output Measure **available to project s who have volunteers currently** 



### 12 **Senior Companion Program Performance Measures Requirements** Your grant application must reflect the Performance Measures Requirements established for the Senior Companion Program, as listed in items A) and B) below. The performance measures are documented as a required part of the work plans submitted as part of your grant application.

At least 90 percent of the unduplicated Senior Companion volunteers must be

-Wi de Priority Measures in Healthy Futures - Independent Living Outcome and/or Complementary Program Measures - Respite Care Outcome

more than 10 percent of the unduplicated Senior Companion volunteers can be placed in assignments that address the Assisted Living Output Measure
. **This option is only**

**s who have volunteers currently in assisted living assignments**  **Senior Companion Program Performance Measures Requirements** Requirements established for the Senior Companion Program, as listed in items A) and B) below. The performance measures are documented as a required part of the work plans submitted as part of your grant application.

At least 90 percent of the unduplicated Senior Companion volunteers must be Independent Living Respite Care Outcome
. more than 10 percent of the unduplicated Senior Companion volunteers can **This option is only in assisted living assignments** 
.

### 13 **PA RT**  **II –**  **SECTION B**  **. STRENGTHENING COMMUNITIES** 

**Must Be Completed by AL**  **L Ap**  **plicants for Competitive Grants Must Be Updated for A** **ccuracy by**  **all Grantees entering Continuation Years** The recommended number of pages for this section is: ______ In your Strengthening Communities Narrative, please respond to the following:
 Describe t he community you serve. Provide persuasive evidence that identify the community needs . For the FGP, this primary focus area is Education. For the SCP, this primary focus area is Healthy Futures
– Independent Living and/or Respite for Caregivers. Use demographic information, census data, or other sources as needed to present your case.  Desc ribe the ways in which the volunteers can serve as effective resources to address the community’s need in the focus area.  Describe the service activities of the volunteers that will lead to National Performance measures
.  Link the following three major el ements in **the primary focus area**  so that the service activities address the need, and result in the anticipated outputs and/or outcomes :

1. the community needs identified, 2. the service activities that will be carried out by FGP or SCP volunteers 3. the anticipated output(s) or outcome(s) **PA RT I**  **I –**  **SECTION C. RECRUITMENT A ND DEVELOPMENT OF VOLUNTEERS** 

**Must Be Completed by AL**  **L Ap**  **plicants for Competitive Grants Must Be Updated for A** **ccuracy by**  **all Grantees entering Continuation Years** The recommend ed number of pages for this section is: ______ In this section of the narrative, please describe:  Your plan and infrastructure to match skilled volunteers with volunteer stations that can benefit from volunteers with specific skills.  Y our plan and infrastructure to develop volunteer assignments with opportunities to acquire skills, develop leadership, reflect on the meaning of service, and enhance the quality of the volunteers’ own lives.  Your plan and infrastructure to recruit disable d FGP or SCP volunteers , including individuals with age related disabilities  Your p lan and infrastructure to retain and recognize the FGP or SCP volunteers

### 14 **PA RT I**  **I –**  **SECTION D. PROGRA M MA**  **NA GEMENT** 

**Must Be Completed by AL**  **L Ap**  **plicants for Competitive Gra nts**  **Must Be Updated for A ccuracy**  **by all Grantees entering Continuation Years**  The recommended number of pages for this section is: _______ In this section, describe specific plans and strategies for overall management of the FGP or SCP project that you p ropose. Please focus your narrative on the following:

 The structure and plans to ensure management of volunteer stations in compliance with FGP or SCP program regulations.  The plans to develop capacity to recruit and manage volunteer stations that addre ss specified community needs outside the primary focus area
.  The p lans and capacity to responsibly graduat e volunteer stations that do not address specific community needs and to minimize disruptions to current volunteers where possible
.  The plan and infrastructure to assure national performance measure outcomes and outputs are measured
.  The plan and infrastructure to manag e project resources, both financial and in - kind, to ensure accountability and efficient and effective use of available resources.
**PA RT**  **II –**  **SECTION E . ORGA**  **NIZA TIONA**  **L CA PA**  **BILITY Must Be Completed by**  **AL L**  **Ap plicants for Competitive Grants**  **Must Be Updated for A ccuracy**  **by all Grantees entering Continuation Years**  Briefly describe your organization’s capacity to operate the FGP or SCP project that you propose with respect to:

 The capability fo r and plans to provide sound programmatic and fiscal oversight, day- to - day operational support and data collection, to include clearly defined internal policies
.  Descriptions of clearly def ined staff positions , including (as applicable) identification of current staff assigned to the project.  Your organization’s track record in the primary focus area, senior service, managing volunteers, and in measuring performance
.  Demonstration of organizational infrastructure, including: (1) Tangible assets such as facilities and equipment, (2) Governance structure and operations, such as internal policies, purchasing procedures, and personnel management, and (3) Role of a community participation gro up, such as an FGP or SCP advisory council, to ensure input from the community.  The existence of robust financial management systems and past experience managing federal grant funds  How your organization will sustain the proposed required non -federal share
.

### 15 **PA RT**  **II –**  **SECTION F. OTHER NOFA REQUIREMENTS**  **– REFERENCE ONLY**  This section is used, as needed, to address any additional program requirements that appear in the published Notice of Funding Availability (NOFA) or supplemental instructions. Refer to the NOFA for specifics.

**PA RT**  **I II**  **– PERFORMA**  **NCE MEA SURES A**  **ND WORK PLA NS**  **– eGRANTS WORK PLA**  **N SECTION Must be completed by**  **all Renewal A pplicants**  **Current FGP grantees** submitting non - competitive c ontinuation a pplications **MUST UPDA TE**  the continuation grant application to reflect any changes from previous submission to ensure the Performance Measures and W ork Plans are aligned to the proposed activities and outcomes in the upcoming year. **PA RT III**  **(a): Foster Grandparent Program (FGP)**

**Per formance Measures and Work Plans**  **- eGrants “Work Plan” Section**  **PA RT IV. SECTION A**  **. 1)**  **Foster Grandparent Program (FGP) Performance Measures** Performance Measures are the means by which FGP grantees demonstrate tangible outcomes and results of the volunteers’ services in the community. Performance Measures include the “what”

– or the indicators; the “how”
– or the tools; and the “proof”
– or the targets. **2) FGP Performance Measures Requirements**  Your grant application must reflect the Performance Measures Requirements established for the Foster Grandparent Program, as listed in items A) and B) below. The performance measures are documented as a re quired part of the Wo rk Plans submitted as part of your grant application. **C) Requirement 1:**  At least 75 percent of the unduplicated Foster Grandparent volunteers must be in work plans address Agency-Wi de Priority Measure Outcomes for K- 12 Success and/or Sch ool Readiness
. **D) Requirement 2:**  No more than 25 percent of the unduplicated Foster Grandparent volunteers can be placed in assignments that address:  Agency-Wi de Outputs in K- 12 Success and/or School Readiness and/or  Complementary Measures Outputs in Child Safety, W elfare, and Health; Education; Economic Opportunity. There are tools available to help you develop your work plans:  The list of FGP Performance Measures can be found in Appendix ____.  The Wo rk Plan Develo pm ent W ork sheets can be found in Appendix ____.

### 16 **3) Ab**  **out Work Plans**

 A Wo rk Plan is **a task plan with action steps** to address a specified community need. In the grant application, these W ork Plans form the basis for a proposed project plan: the need the volunteers will address, what they will do, what their service should accomplish for each 12 - month performance period of the grant.  Wo rk Plans follow a standard format.  Wo rk Plans capture the focus of the volunteers’ services in standard categories. These include **Focus A reas and Service A** **ctivities. 4)**  **How many Work Plans are needed?**  The number of Wo rk Plans needed is determined by how you place your volunteers, and by the types of service activi ties they will undertake. **5) How** **are Work Plans completed?** Data that you enter into the **eGrants Performance Measures Module** (PMM) are the basis for your work plans. As you enter data on the community need and select your outcomes, outputs, service activities and other information, the eGrants PMM will build your work plans for you. Attachment ____ consists of worksheets desig ned to help you plan your performance measures. These worksheets can help to organize how you will fit your performance measures together with the volunteer activities. W e recommend that you use the worksheets and instructions to map out your work plans, a nd then use the completed worksheets to transfer the information into the eGrants PMM. Please click here fo r step - by- step instructions on how to use the eGrants PMM. **6) Which sections of the Work Plans must be completed**  **and what is the purpose of each sectio n**  **?** The following sections must be completed for all outcome work plans addressing the requirement of **75 percent of Foster Grandparent volunteers serving in**  **Ag ency**  **- Wide Priority**  **Measure Outcomes for K**  **- 12 Success and/or School Readiness** 
. **(a) Description of**  **C ommunity Need**  **:** The description of the community need must be completed for each output you select. This needs statement should explain the compelling need that will be addressed by the volunteers. W hen you develop your community need, be sure to:  Describe the need in enough detail to convey its importance in the community. Use of local statistics can be helpful to make your case.  Describe the consequences of the need going unmet in the community.  Describe why Foster Grandparent volunteers can be effective resources to meet the need.  Describe the need in a way that is clear to people unfamiliar with your community. Do not assume that other readers have an existing understanding. **(b) Primary** 

**Focus Ar** **ea and Objective:** the Focus Area and Objective must be completed by selecting the correct options on the pull down menus in the eGrants PMM. **(c) O**  **utput:** Outputs are the immediate results of the volunteers’ services. These are usually counts
– numbers of children served, etc. The output is selected using the pull down menu in the eGrants PMM.  The list of Service Activities, which are part of each work plan you develop can be found in Appendix ____. 

###  A list of Suggested Tools and Instruments, which can be used to measure your results can be found in Appendix ____.

### 17

**(d) Service A** **ctivity :**  The service activity is the actual task (such as tutoring, mentoring) that the volunteers will perform. For each output, you may select more the one service activity. The service activities are selected using the pull down menu in the eGrants PMM. **For each service activity selected, the eGrants PMM will create a s**  **eparate work plan**
. **(e) Number of Unduplicated Volunteers:**  This is the proposed number of volunteers who will be performing each service activity. Each volunteer can only be counted once when assigned to a service activity. The volunteer should be counted in t he area where he/she will make the most impact
– in terms of the type of service or in terms of the scope of service, such as the most number of hours served. **(f) Total Number of Volunteers:**  Here, you enter the total volunteers engaged in the activities, if you were to assign all of them according to each activity. In this way, volunteers **can** be counted more than once
– fo r example, if the same volunteer does two different types of activities such as tutoring AND mentoring, you can account for both assignments in this field. **(g) Targets:**  The target is the number that you anticipate achieving in the performance period (usually 12 months). For example, if you think your volunteers will serve 50 children in Head Start over the course of the performance period, you wo uld enter 50 as your target. **(h) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGrants PMM. **(i) Outcome:**  Outcomes are the longer term or permanent change or improvement expected in the community due to the volunteers and their services. The outcome is selected using the pull down menu in the eGrants PMM. As noted in the requirement sections, a minimum of 10 percent of your total unduplicated volunteers must be in assignments with outcomes **(j) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGrants PMM. **6.1 Which sections of the Work Plan must be completed for the no more than 25 percent of**  **unduplicated Foster Grandparent volunteers can be placed in assignments that address:**  **Ag ency**  **- Wide Outputs in K**  **- 12 Success and/or School Readiness and/or**   **Complementary**

**Meas ures Outputs in Child Safety**  **, Welfare, and Health; Education; Economic Opportunity**  **. (a)**  **Description of C**  **ommunity Need :**  The description of the community need must be completed for each output you select. This needs statement should explain the compelling nee d that will be addressed by the volunteers. Wh en you develop your community need, be sure to:  Describe the need in enough detail to convey its importance in the community. Use of local statistics can be helpful to make your case.  Describe the consequences of the need going unmet in the community.  Describe why Foster Grandparent volunteers can be effective resources to meet the need.  Describe the need in a way that is clear to people unfamiliar with your community. Do not assume that other readers have an ex isting understanding. **(b) Primary** 

**Focus Ar** **ea and Objective:** For FGP, the Primary Focus Area is Education. The Objectives must be completed by selecting the correct options on the pull down menus in the eGrants PMM.

### 18

**(c) O**  **utput:** Outputs are the immediate results of the volunteers’ services. These are usually counts
– numbers of children served, etc. The output is selected using the pull down menu in the eGrants PMM. **(d) Service A** **ctivity :**  The service activity is the actual task (such as tutoring, mentoring) that the volunteers will perform. For each output, you may select more the one service activity. The service activities are selected using the pull down menu in the eGrants PMM. **For each service activity selected, the**  **eGrants PMM wi ll create a separate work plan** 
. **(e) Number of Unduplicated Volunteers:**  This is the proposed number of volunteers who will be performing each service activity. Each volunteer can only be counted once when assigned to a service activity. The volunteer should be counted in the area where he/she will make the most impact
– in terms of the type of service or in terms of the scope of service, such as the most number of hours served. **(f) Total Number of Volunteers:**  Here, you enter the total volunteers engaged in the activities, if you were to assign all of them according to each activity. In this way, volunteers **can** be counted more than once
– for example, if the same volunteer does two different types of activities such as tutoring AND mentoring, you can account for both assignments in this field. **(g) Targets:**  The target is the number that you anticipate achieving in the performance period (usually 12 months). For example, if you think your volunteers will serve 50 chil dren in Head Start over the course of the performance period, you would enter 50 as your target. **(h) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGran ts PMM.

### 19 **PA RT III**  **(b): Senior Companion Program (SCP):**

**Performance Measures and Work Plans -**  **eGrants “Work Plan” Section**

**Must be completed by all Renewal A** **pplicants Current SCP grantees**  submitting non - competitive c ontinuation a pplications **MUST UPDA TE**  the continuation grant application to reflect any changes from previous submission to ensure the Performance Measures and W ork Plans are aligned to the proposed activities and outcomes in the upcoming year. **PA RT III**  **. SECTION A .**  **1) Senior Companion**  **Program ( SC**  **P) Performance Measures** Performance Measures are the means by which SCP grantees demonstrate tangible outcomes and results of the volunteers’ services in the community. Performance Measures include the “what”

– or the indicato rs; the “how”
– or the tools; and the “proof”
– or the targets. **2) SCP Performance Measures Requirements**  Your grant application must reflect the Performance Measures Requirements established for the Senior Companion Program, as listed in items A) and B) b elow. The performance measures are documented as a required part of the Wo rk Plans submitted as part of your grant application. **C) Requirement 1:**  At least 90 percent of the unduplicated Senior Companion volunteers must be in work plans address Agency-Wi de Priority Measures in Healthy Futures - Independent Living Outcome and/or Complementary Program Measures - Respite Care Outcome
. **D) Requirement 2:**  No more than 10 percent of the unduplicated Senior Companion volunteers can be placed in assignments that address the Assisted Living Output Measure
. **This option is only available to projects who have volunteers currently**  **in assisted living assignments**
.

**3) Ab**  **out Work Plans**

 A Wo rk Plan is **a task plan with action steps** to address a specified community need. In the grant application, these W ork Plans form the basis for a proposed project plan: the need the volunteers will address, what they will do, what their service should accomplish for each 12 - month performance perio d of the grant. There are tools available to help you develop your work plans: 

###  The list of SCP Performance Measures can be found in Appendix ____. 

###  The W ork Plan Development W orksheets can be found in Appendix
____. 

###  The list of Service Activities, which are part of each wo rk plan you develop can be found in Appendix ____. 

###  A list of Suggested Tools and Instruments, which can be used to measure your results can be found in Appendix ______.

### 20

 Wo rk Plans follow a standard format.  Wo rk Plans capture the focus of the volunteers’ services in standard categories. These include **Focus A reas and Service A** **ctivities. 4)**  **How many Work Plans are needed?**  The number of work plans needed is determined by how you place your volunteers, and by the types of service activities they will undertake. **5) How** **are Work Plans completed?** Data that you enter into the **eGrants Performance Measures Module** (PMM) are the basis for your work plans. As you enter data on the community need and select your outcomes, outputs, service activities and other information, the eGrants PMM will build your work plans for you. Attachment ____ consists of worksheets desig ned to help you plan your performance measures. These worksheets can help to organize how you will fit your performance measures together with the volunteer activities. W e recommend that you use the worksheets and instructions to map out your work plans, a nd then use the completed worksheets to transfer the information into the eGrants PMM. Please click here fo r step - by- step instructions on how to use the eGrants PMM. **6) Which sections of the Work Plans must be completed and what is the purpose of each sectio**  **n? A)**  The following sections must be completed for all outcome work plans addressing the requirement of **90 percent of Senior Companion volunteers serving in A gency**  **- Wide Priority**  **Measures in Healthy** 

**Futures -**  **Independent Living Outcome and/or Complementary P**  **rogram Measures**  **- Respite Care Outcome.**  **(a) Description of**  **C ommunity Need**  **:** The description of the community need must be completed for each output you select. This needs statement should explain the compelling need that will be addressed by the volunteers. Wh en you develop your community need, be sure to:  Describe the need in enough detail to convey its importance in the community. Use of local statistics can be helpful to make your case.  Describe the consequences of the need going unmet in the community.  Describe why Senior Companion volunteers can be effective resources to meet the need.  Describe the need in a way that is clear to people unfamiliar with your community. Do not assume that other readers have an existing understanding. **(b) Primary** 

**Focus Ar** **ea an d Objective:**  the Focus Area and Objective must be completed by selecting the correct options on the pull down menus in the eGrants PMM. **(c) O**  **utput:** Outputs are the immediate results of the volunteers’ services. These are usually counts
– numbers of clients se rved, etc. The output is selected using the pull down menu in the eGrants PMM. **(d) Service A** **ctivity :**  The service activity is the actual task (such as tutoring, mentoring) that the volunteers will perform. For each output, you may select more the one service a ctivity. The service activities are selected using the pull down menu in the eGrants PMM. **For each service activity selected, the eGrants PMM will create a separate work plan** 
. **(e) Number of Unduplicated Volunteers:**  This is the proposed number of volunteers wh o will be performing each service activity. Each volunteer can only be counted once when assigned to a service activity. The volunteer should be counted in the area where he/she will make the most

### 21

impact
– in terms of the type of service or in terms of the scope of service, such as the most number of hours served. **(f) Total Number of Volunteers:**  Here, you enter the total volunteers engaged in the activities, if you were to assign all of them according to each activity. In this way, volunteers **can** be counted mo re than once
– fo r example, if the same volunteer does two different types of activities such as companionship AND transportation, you can account for both assignments in this field. **(g) Targets:**  The target is the number that you anticipate achieving in the p erformance period (usually 12 months). For example, if you think your volunteers will serve 50 clients over the course of the performance period, you would enter 50 as your target. **(h) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGrants PMM. **(i) Outcome:**  Outcomes are the longer term or permanent change or improvement expected in the community due to the volunteers and their services. The outcome is select ed using the pull down menu in the eGrants PMM. As noted in the requirement sections, a minimum of 10 percent of your total unduplicated volunteers must be in assignments with outcomes **(j) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGrants PMM. **6.1 Which sections of the Work Plan must be completed for the no more than**  **10 percent of**  **unduplicated Senior Companion voluntee**  **rs can be placed in assignments**  **that address the As**  **sisted Living Output Measure ?**  **(a) Description of**  **C ommunity Need**  **:** The description of the community need must be completed for each output you select. This needs statement should explain the compelling need th at will be addressed by the volunteers. Wh en you develop your community need, be sure to:  Describe the need in enough detail to convey its importance in the community. Use of local statistics can be helpful to make your case.  Describe the consequences of t he need going unmet in the community.  Describe why Senior Companion volunteers can be effective resources to meet the need.  Describe the need in a way that is clear to people unfamiliar with your community. Do not assume that other readers have an existing understanding. **(b) Primary** 

**Focus Ar** **ea and Objective:** For SCP, the Primary Focus Area is Healthy Futures. The Objective is Aging in Place. Complete these items by selecting the correct options on the pull down menus in the eGrants PMM. **(c) O**  **utput:** Outputs are the immediate results of the volunteers’ services. These are usually counts
– numbers of clients served, etc. The output is selected using the pull down menu in the eGrants PMM. **(d) Service A** **ctivity :**  The service activity is the actual task (such a s tutoring, mentoring) that the volunteers will perform. For each output, you may select more the one service activity. The service activities are selected using the pull down menu in the eGrants PMM. **For each service activity selected, the**  **eGrants PMM wil l create a separate work plan** 
. **(e) Number of Unduplicated Volunteers:**  This is the proposed number of volunteers who will be performing each service activity. Each volunteer can only be counted once when assigned to a service

### 22

activity. The volunteer should be counted in the area where he/she will make the most impact
– in terms of the type of service or in terms of the scope of service, such as the most number of hours served. **(f) Total Number of Volunteers:**  Here, you enter the total volunteers engaged in the activities, if you were to assign all of them according to each activity. In this way, volunteers **can** be counted more than once
– for example, if the same volunteer does two different types of activities such as companionship AND transportation, you can account for all assignments in this field. **(g) Targets:**  The target is the number that you anticipate achieving in the performance period (usually 12 months). For example, if you think your volunteers will serv e 50 clients over the course of the performance period, you would enter 50 as your target. **(h) Instrument used for Tracking Output:**  This is the tool that will be used for data collection. The Instrument is selected using the pull down menu in the eGrants PMM
.

### 23 **PA RT**  **I V.**  **REQUIRED SUPPLEMENTA L DOCUMENTS**  **LIST (eGrants “Documents” Section)**  **Required Supplemental Documents for New and Continuation Ap**  **plicants**

**Required Supplemental Documents for New and Continuation A** **pplicants New** **A pplicants**  **Continuation Ap**  **plicants** Board of Directors Only if changed Community Advisory Group names and addresses Only if changed Negotiated Indirect Cost Agreement Negotiated Indirect Cost Agreement Organizational Chart Only if changed Project Director’s Job Description O nly if changed Roster of Volunteer Stations Roster of Volunteer Stations Statement of date of last A133 audit Statement of date of last A133 audit **Ad d**  **a new** Annual Assessment of Accomplishments and Impact of the Project

### 24 **PA RT**  **V –**  **BUDGET INSTRUCTIONS: eGrants Budget Sections Refer to the egrants Step**  **- by**  **- Step Instructions for entering y** **our budget. (a) Multi**  **- year applications**  - Complete the SF 424A Budget form requesting funds for the first annual budget period, following the instructions below. Multi - year project approval does not guarantee that the application will be approved for additional funding. If we approve an appli cation and enter into a multi - year award agreement, we will issue a Notice of Grant Award (NGA) that will provide funding only for the first year. You must submit a continuation application, via eGrants, for each year of the award to request additional fu nding. Wewill use the distribution of line item amounts proposed for the first year in budgeting for subsequent years unless you submit an application for revising the budget. Your Corporation State Office will provide instructions for continuation app lications. Following receipt of a Notice of Grant Award (NGA), you may submit applications for revision of your budget via eGrants. **(b) Single -** **year applications** - Complete the SF 424A Budget form for the 12 - month period, following the instructions below . Unless otherwise instructed by an agent of the Corporation, or referenced in the Notice or supplemental guidance, all grants are multi - year. **General Instructions for SF 424A Budget form Columns 1, 2, 3, and 4:**  (b) In Column 1, enter the total project cost for that line item from all sources. (c) In Column 2, enter the amount of Corporation funding requested for each line item and the total. (d) In Column 3, enter the amount of funds for the item that is expected to be covered by grantee funds or funds the grante e expects to receive from other sources, including cash and in - kind support. (e) Required Non - Federal Share: Please see table below. In cases of demonstrated need, as specified in the respective program regulations, exceptions to these cost - sharing requirements may be allowed. **Program Required Non**  **- Federal Share**  FGP and SCP New Applicants that do not currently sponsor an FGG or SCP project:

10% of the total project cost Current FGP or SCP sponsors applying for a renewal or continuation grant in their current geographic service area : 10% of the total project cost (f) Enter any contributions in **excess of required non -** **federal share in optional Column 4** , as stipulated in Section 224 of the Domestic Volunteer Service Act, as amended. (g) For each Budget Line Item, please:  Briefly describe all amounts in Columns 2, 3, and 4
. Below are the following instructions for each line item of the budget form. **PA RT**  **V –**  **SECTION A .**  **VOLUNTEER SUPPORT SERVICES Source of Matching Funds:**  Please fill in the sources of non -fe deral share at the beginning of eGrants Sections I and II.

### 25

NOTE: For all line items, please put the total cost in Column 1 and then use Columns 2
– 4 to identify the source of funds as appropriate: **Line A . Project Personnel Expenses**  **–** List the title of each staff position charged to the project. List all positions/titles that are either funded by CNCS, grantee share, or excess resources. Include: 1. The position title. 2. The full - time equivalent (FT E) annual salary. 100% FTE is normally 40 hours/week. Thus, if an employee works half time or 20 hours/wk for the project and is paid $10,000 from project funds, the FTE annual salary would be $20,000. 3. The percentage of time the person will work for t he project over a 12 month year (for example, if the employee works 10 hours per week for the project over 12 months, you would enter 25%.). **Line B. Personnel Fringe Benefits –**  Enter in the appropriate column the cost of fringe benefits to wh ich employees are entitled, calculated on the same percentage time indicated under line A for each individual. In your Budget Narrative, provide details concerning the benefits provided. ( e.g ., Retirement contributions for all staff working over 60% time, calculat ed at 5% of total annual salaries of $80,000 = $4,000). **Line C. Project Staff Travel –**  Enter travel costs on the local or long - distance lines, as appropriate, on the Budget form. Include only travel costs for staff listed under budget line A and who dire ctly support the grant activities described in your application. Local travel is travel within the project service area as shown in item 12 of the Face Sheet. All travel outside the service area is long distance travel. Briefly list the purpose of antic ipated local travel and the basis for cost calculations. For long distance travel, show the purpose for each trip and break out for each the cost of transportation, meals and lodging, and other travel costs. **Line D. Equipment -**  Enter on the Budget form the cost of equipment. Items costing less than $5,000 should be listed in supplies. **Line E: Supplies** . List the types of supplies and their respective costs. Please itemize large items. **Line F. Contractual and Consultant Services -**  Enter the cost of contracts and consultants as appropriate. In your Narrative itemize each contract or consultant and provide a brief justification of the need for each. Include here all services documented in a contract, such as clerical support, training consultants, eq uipment repair and maintenance, or bookkeeping services. **Line G. Other Volunteer Support Costs –**  Brief ly d escribe all other allowable Volunteer Support Expenses not included in categories A through F, such as criminal history background checks, training, evaluation services, and other items and briefly describe.
 All employees or other individuals who receive a salary or similar payment from the grant (federal or non -federal share). **Line H. Indirect Costs –**  Enter indirect charges applicable to volunteer support expenses. In your Narrative, describe the type of rate (provisional, predetermined, final or fixed) in effect during the budget period, estimated amount of the base to which the indirect rate was applied, and total indirect expense. Attach a copy of the current negotiated indirect cost agreement with the cognizant federal agency.

### 26

**TOTA L**  **BUDGET SECTION I**  - Enter the sum of direct and indirect costs from Section I in columns 1, 2, 3, and 4 as appropriate. **PA RT**  **V –**  **SECTION B .**  **VOLUNTEER EXPENSES**  **Line A . Stipends**  **–** Stipends are applicable to Foster Grandparent and Senior Companion volunteers only. Please enter as appropriate the number of Volunteer Service Years (VSYs) proposed in each category and multiply the numbers of VSYs times the annual stipend. Note: Current annual stipend is $2,766 based on 1 VSY @ 1,044 hours x hourly stipend of $2.65

**DO NOT** include monetary incentives for Senior Companion Leaders in the stipend line item. 1. CNCS - funded ____ x Annual Stipend = $_________ 2. Non - CNCS -funded ____x Annual Stipend = $______ 3. Non - Stipended: ____ NOTE: Volunteer Service Year (VSY) is a budget term which equals 1,044 hours per year. For example, a volunteer serving 2088 hours per year (averaging 40 hours per week) serves 2 VSYs, while a volunteer serving 783 hours per year (averaging 15 hours per week) serves 3⁄4 of a VSY. **Line B. Other Volunteer Costs**
– Enter in the respective categories the applicable costs and reimbursable expenses in columns 1, 2, 3, and 4, as appropria te. In addition to stipends, FGP and SCP allowable costs and reimbursable expenses include: Insurance, Volunteer Travel, Physical examinations, Meals, Uniforms, and Recognition. FGP and SCP allowable costs and reimbursable expenses include: Volunteer Travel, Meals, Recognition, and Insurance. Volunteers may also be reimbursed for costs incurred while performing assignments
– including transportation, equipment, supplies, etc.
– provided such costs are described in the Memorandum of Understanding negotiated with the volunteer station where the volunteer is assigned and there are sufficient funds available to cover these expenses and meet all other requirements of the NGA. For SCP only, monetary incentives for Senor Companion Leaders should be listed in #7: Other Allowable Expenses. Use the Narrative for the corresponding line to provide explanation or show calculations, as needed. **Note on Volunteer Travel:** Volunteer Travel includes volunteer transportation costs such as cost of agency vehicles (leased or purchased), insurance, prorated maintenance costs applicable to vehicles based on usage, and drivers’ salaries and fringe benefits chargeable to the grant. Assignment- related travel is also a llowable. Please enter the totals for columns 1, 2, 3, and 4 as appropriate. **TOTA L**  **BUDGET SECTION II** 
– The sum of Volunteer Expenses in Section II. **TOTA L PROJECT COSTS** 
– The sum of the totals for Sections I and II in each column. **FUNDING PERCENTA GES** 
– Tot als will auto - calculate in eGrants.

### 27 **PA RT VI**  **– FUNDING/DEMOGRA**  **PHICS INSTRUCTIONS: Estimated Funding**  **Line A . Total** 
– The sum of the totals for Sections I and II will auto - calculate from sections A and B of your Budget. **Line B. Federal Share**
– The sum of the totals for Federal funding will auto - calculate from section A and B of your Budget. **Line C. A pplicant Share**  - The sum of the totals for Grantee funding will auto - calculate from section A and B of your Budget. **Line D. A pplicant Share Breakdown** 
– E nter the breakdown of the applicant share into the following sources. The sum of the source amounts must add up to Line C. **Line E. Demographics** - Enter the total number of unduplicated volunteers
.

### 28 **CONTINUA**

**TION AP**  **PLICA**

**TION INSTRUCTIONS Must be completed by**  **current grantees submitting a non -**  **competitive continuation request for year 2**

**or 3 of the multi**  **- year grant.**  Contact your CNCS State Office for specific timeframes for continuation application submission. **How to Submit Your Continuation Request:**   From your eGrants home page, click **Continuation/Renewal.** A list of applications for your organization will be displayed.  Click **Continue** next to the application that you plan to update and submit for your continuatio n. Be sure to select the correct application.  Next you will see a list of Notice options. Your CNCS St ate Office will provide you with the appropriate NOFA to select.  After the NOFA is selected, eGrants creates the continuation application which will in clude a copy of all information from your previously awarded application. Edit your continuation application as directed in the continuation request instructions below.  Wh en you have completed your edits, your Authorized Representative should login with their eGrants account and click the **SUBMIT** button. If you have questions about the content of your continuation, please contact your CNCS State Office. **If y ou**  **experience problems using eGrants, contact the eGrants Help Desk at (800) 942**  **- 2677.**  **What to Include in Your Continuation Request:**  **I. A pplicant Info**  **, Ap**  **plication Info and Funding/Demographics**  Update only if there have been significant changes at your project or organization
. **II. Narratives** The Executive Summary should be reviewed and updated t o ensure that the outcomes reflect any changes made in the Wo rk Plans. All other narratives should only be updated if the information is no longer accurate due to project or sponsor organization changes. If the narrative information is accurate, leave it unchanged in the continuation application. **III. Work Plan**  Information will copy from your previous ly awarded application into your continuation application
. Wo rk Plans are designed to align with the 12 - month performance period. Update the W ork Plans as needed to reflect the upcoming performance period for the continuation. **IV. Documents** Refer to the Continuation column on pages ___ and send the required documents to your CNCS State Office. **V . Budget**  Update the budget for the upcoming year. Incorporate any changes such as a new source of non -federal funds, adjustments to recognition, or personnel changes. The non -federal share must increase to 20% in year 2 and 30% in year 3 and subsequent years.

### 29 **PA RT I**  **– FA** **CESHEET OMB No. 3045**  **- 0035**  **Expiration Date ______ AP**  **PLICA**

**TION FOR FEDERA L A** **SSISTA NCE**  1. TYPE OF SUBMISSION: Application Non - Construction 2. DATE SUBMITTED TO CORPORATION FOR NATIONAL AND COMMUNITY SERVICE (CNCS): 3. a. DATE RECEIVED BY STATE: 3.b. STATE APPLICATION IDENTIFIER: 4. a. DATE RECEIVED BY CNCS: 4.b. CNCS GRANT NUMBER: 5. APPLICANT INFORMATION LEGAL NAME: ORGANIZATIONAL UNIT: NAME AND CONTACT INFORMATION FOR PROJECT DIRECTOR OR OTHER PERSON TO BE CONTACTED ON MATTERS INVOLVING THIS APPLICATION (give area codes): ADDRESS (give street address, city, county, state and zip code): NAME: TELEPHONE NUMBER: ( ) - FAX NUMBER: ( ) - INTERNET E - MAIL ADDRESS: WEBSITE: 6. EMPLOYER IDENTIFICATION NUMBER (EIN): 6A. DUNS Number: 7.a. TYPE OF APPLICANT: (enter appropriate letter in box) A. State H. Independent School District B. County I. State Institution of Higher Learning C. Municipal J. Private University D. Township K. Indian Tribe E. Interstate L. Individual F. Intermunicipal M. Profit Organization G. Special District N. Private Non - Profit Organization O. Other (specify) 7.b. CNCS APPL ICANT CHARACTERISTICS Enter appropriate code in each blank: ______, ______, ______, 8. TYPE OF APPLICATION (Check appropriate box): NEW CONTINUATION REVISION If Revision, enter appropriate letter(s) in box(es): A. Increase Award: B. Decrease Award: C. Increase Duration: to (enter date) D. Decrease Duration: to (enter date) E. OTHER (specify): 9. NAME OF FEDERAL AGENCY: Corporation for National and Community Service 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: Name of Program ___________-

__________________________________________ 11. a. TITLE OF APPLICANT’S PROJECT:

12. AREAS AFFECTED BY PROJECT (List Cities, Counties, States, etc.): 14. PERFORMANCE PERIOD: Start Date End Date:
13. PROPOSED PROJECT: START DATE: END DATE: 15. ESTIMATED FUNDING: Check applicable box: Yr 1: Yr.2: or Yr 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE a. FEDERAL $ ORDER 12372 PROCESS? a. Y ES. T HIS PREAPPLICATION/APPLICATION WAS MADE b. APPLICANT $ TO THE STATE EXECUTIVE ORDER 12372 PROCESSS FOR REVIEW ON: c. STATE $ DATE ___________________________________ b. NO. PROGRAM IS NOT COVERED BY E.O. 12372 d. LOCAL $ OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW e. OTHER $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? f. TOTAL $ YES If “Yes,” attach an explanation. NO 18. TO THE BEST OF MY KNOWL EDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WI TH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. a. TYPED NAME OF AUTHORIZED REPRESENTATIVE: b. TITLE: c. TELEPHONE NUMBER: d. SIGNATURE OF AUTHORIZED REPRESENTATIVE: e. DATE SIGNED: 

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### 30 Modified Standard Form 424 - NSSC (Rev. 3/03 to conform to the CNCS eGrants system)

### 31 **ROSTER OF A CTIVE**  **VOLUNTEER STA TIONS**  **INSTRUCTIONS** The accompanying template in Excel corresponds to these instructions. The Volunteer Station Roster must be completed using the MS Excel workbook template. The workbook template contains the following parts: Tab 1: Instructions Tab 2: Volunteer Station Roster template Tab 3: Volunteer Station Types The purpose of this form is to provide information about each active volunteer station. For **New A** **pplicants** : The definition of “active volunteer station” is any volunteer station where you intend to place RSVP volunteers if the grant application is funded. If the grant application is funded, the Volunteer Station Roster will be updated at a later time to reflect actual volunteer placement. The definition of “active volunt eer station” is any volunteer station with which you have an MOU. Please make every effort to provide complete and accurate data. For each header item with a small red triangle in the upper right corner of the cell: if you place your cursor over the cell a nd wait a few seconds (“hover”), a “pop - up” comment box, with further description, will appear. Note that the spreadsheet will “scroll” up and down, leaving the column names and station names visible at all times. Please do not change the location of each data item (e.g., moving cells or columns), as this is a standardized form.

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PUBLIC BURDEN STATEMENT: Public reporting burden for this collection of information is estimated to average 5 hours per submission, including reviewing instructions, gathering a nd maintaining the data needed, and completing the form. Comments on the burden or content of this instrument may be sent to the Corporation for National and Community Service, Attn: Am y Borgstrom, 1201 New York Avenue, N W, Wa shington, D.C. 20525. The Corp oration informs people who may respond to this collection of information that they are not required to respond to the collection of information unless the OMB control number and expiration date displayed on page 1 are current and valid. (See 5 C.F.R. 1320. 5(b)(2)(i).) PRIVACY ACT NOTICE: The Privacy Act of 1974 (5 U.S.C § 552a) requires that the following notice be provided to you: The information requested on the Senior Corps Grant Application is collected pursuant to 42 U.S.C 12592 and 12615 of the Nati onal and Community Service Act of 1990 as amended, and 42 U.S.C. 4953 of the Domestic Volunteer Service Act of 1973 as amended. Purposes and Uses - The information requested is collected for the purposes of reviewing grant applications and granting funding requests. Routine Uses - Routine uses may

include disclosure of the information to federal, state, or local agencies pursuant to lawfully authorized requests. In some programs, the information may also be provided to federal, state, and local law enforcem ent agencies to determine the existence of any prior criminal convictions. The information may also be provided to appropriate federal agencies and Department contractors that have a need to know the information for the purpose of assisting the Department’ s efforts to respond to a suspected or confirmed breach of the security or confidentiality or information maintained in this system of records, and the information disclosed is relevant and unnecessary for the assistance. The information will not otherwise be disclosed to entities outside of the Corporation for National and Community Service without prior written permission. Effects of Nondisclosure - The information requested is mandatory in order to receive benefits. OMB Control Number 3045 - 0035 Expiration Date 6/30/2014