Appendix D- Attach-ment 3_Disclosure of DFC Support Program Funding.docx
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- CDC-RFA-CE21-2103
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Appendix D- Attach-ment 3_Disclosure of DFC Support Program Funding.docx
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| File | Type | Posted |
|---|---|---|
| Foa_Content_of_CDC-RFA-CE21-2103_revised020421.pdf | ||
| Foa_Content_of_CDC-RFA-CE21-2103 (5).pdf | ||
| Appendix D- Attach-ment 1_Assurance of Legal Eligibility.docx | DOCX document | |
| Appendix D- Attach-ment 2_MOU_.docx | DOCX document | |
| Appendix D- Attach-ment 5_Coalition Meeting Minutes.docx | DOCX document | |
| Appendix D- Attach-ment 7_CARA Act Program Evaluation Requirements.docx | DOCX document | |
| Appendix D- Attach-ment 8_General Applicant Information.docx | DOCX document | |
| Appendix D- Attach-ment 9_Sample Congressional Notification.docx | DOCX document | |
| Appendix C - Review and Selection Process.docx | DOCX document | |
| Appendix D- Attach-ment 6_Key Personnel Resumes.docx | DOCX document | |
| Appendix B- Resources on Evidence-Based and Practice-Based Strategies and Activities.docx | DOCX document | |
| Appendix D- Attach-ment 4_Statement of Rates.docx | DOCX document | |
| Appendix A - Pre-Submission Verification Checklist for CARA.docx | DOCX document |
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Attachment 3 – Disclosure of Drug-Free Communities Support Program Funding Please identifying the category that represents the applicant coalition:
☐ Former DFC Grant Award Recipient ☐ Current DFC Grant Award Recipient
| Former or Current DFC Grant Award Number |
| Legal Applicant/Grant Award Recipient Name |
| Coalition Name |
| Years of Funding |
By signing below, I attest that the [Name of Coalition] is either a current of former DFC grant award recipient and therefore eligible to apply for the FY 2021 CARA local Drug Crises Grants. I also attest the information provided in the table is true and correct.
Official Coalition Representative’s Name (Print)
Official Coalition Representative’s Signature
Date
Legal Applicant/Grant Recipient Representative’s Name (Print)
Legal Applicant/Grant Recipient Representative’s Signature
Date
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