FY22 FDPNE Application Template.docx

SECTION 1: Cover Sheet - Applicant Information (one page)

Food Distribution Program Nutrition Education (FDPNE) Project Proposal Grant Application - Fiscal Year 2022

CFDA#: 10.594

Organization Name:

Organization Address:

Name of Contact Person and Title:

Project Director:

Name of Authorizing Official:

Email Address:

Phone Number:

FDPNE GRANT APPLICATION TEMPLATE

Section 2: Table of Contents (one page)

SECTION 3: Organization Information (two pages max) Instructions: Use the space below to describe your organization. Providing a list or a narrative statement is acceptable. Include the following and delete the prompt text once it is no longer needed.

a) Administrative structure of the organization and FDPIR. (You may submit the same background information included in your FDPIR Plan of Operation.)

b) Average number of FDPIR households served per month and average number of FDPIR participants served per month.

c) Brief description of current or past nutrition education efforts as well as any resources available and partnerships.

d) Project Partner information (name, location, and a brief description).

SECTION 4: PROJECT OBJECTIVES (one page) Instructions: You must select one (or more) objective(s) from the list below (#1-4). For each objective selected, you must also designate one (or more) nutrition-related outcome(s) (letters a-d) you hope to achieve with your project. Place an X on the line(s) below to select your objective(s) and outcome(s).

1) Create and/or disseminate culturally relevant nutrition education resources (posters, handouts, videos, cookbooks) that encourage participants to work towards one or more of the nutrition-related outcomes:

a. Make half your plate fruits and vegetables. Focus on whole fruits and vary your veggies.

b. Reduce sodium intake.

c. Make half your grains whole grains.

d. Vary your proteins. Meat and poultry selections should be lean or low-fat.

e. Move to fat-free or low-fat dairy products.

2) Conduct community outreach (healthy cooking demo, nutrition education games, and nutrition handouts, healthy recipe distribution) at community events, health fairs, gatherings, and/or celebrations that promotes one or more of the following nutrition-related outcomes targeting FDPIR eligible participants:

a. Make half your plate fruits and vegetables. Focus on whole fruits and vary your veggies.

b. Reduce sodium intake.

c. Make half your grains whole grains.

d. Vary your proteins. Meat and poultry selections should be lean or low-fat.

e. Move to fat-free or low-fat dairy products.

3) Improve nutrition-related skills among FDPIR participants by conducting healthy cooking and food demonstrations and/or nutrition and wellness classes or activities demonstrating the utilization of foods included in the USDA FDPIR food package to accomplish one or more of the following nutrition-related outcomes:

a. Make half your plate fruits and vegetables. Focus on whole fruits and vary your veggies.

b. Reduce sodium intake.

c. Make half your grains whole grains.

d. Vary your proteins. Meat and poultry selections should be lean or low-fat.

e. Move to fat-free or low-fat dairy products.

4) Develop and/or implement community tribal wellness policies or practices at community events, gatherings, and celebrations that reinforce one or more of the following nutrition-related outcomes:

a. Make half your plate fruits and vegetables. Focus on whole fruits and vary your veggies.

b. Reduce sodium intake.

c. Make half your grains whole grains.

d. Vary your proteins. Meat and poultry selections should be lean or low-fat.

e. Move to fat-free or low-fat dairy products.

SECTION 5: PROJECT SUMMARY (two pages max) Instructions: Use the space below to provide a summary of the project. The following information must be included. Delete the prompt text when it is no longer needed.

a) If you are a previous FDPNE grant recipient, please include a brief summary on how you have previously met reporting requirements, demonstrated success on prior grant projects, and/or how the current proposed project and requested funds will build upon or compliment prior grant projects. Please keep in mind, your proposal should not duplicate past projects.

b) What are you hoping to achieve by conducting this project?

c) Provide a high-level summary of the overall project including the activities you will conduct and how the activities will help you achieve your selected project objective(s).

d) The number of participants you will reach with your project, and the results you expect.

e) Designate a Project Director/Coordinator. Write the name of that person or indicate that you intend to hire a person to fulfill this position. It is recommended that a Project Director contribute a minimum of 25% of their time to oversee complex projects.

f) Provide a list of staff that will work on the project and explain their responsibilities.

g) Target Audience: Provide brief details about who will benefit from your nutrition education activities. For example, FDPIR participants or those eligible, reservations they reside on, their ages and gender, and other program sites where recruitment will occur.

h) Document how activities may continue after the funding period ends. Projects should be designed with sustainability in mind.

i) List all organizations, agencies, or individuals who will provide or assist with nutrition education or nutrition services and describe the assistance they will provide.

j) If the applicant is a consortium, identify the member organizations of the consortium. Attach Memoranda of Agreements from all participating FDPIR programs.

k) Written agreements. Describe agreements and collaborations with sub-grantees and other programs or organizations. Attach Memoranda of Agreements or letters of support/commitment with sub-grantees and partners and submit with your application. Sub-grantees must sign an agreement with the FDPIR allowance holder that documents programmatic and fiscal agreement between the FDPIR allowance holder and the sub-grantee. Submit the agreement with your application.

Note: Written agreements do not count toward the 2-page project summary limit.

SECTION 6: PROJECT ACTIVITY TIMELINE & INDICATORS (two pages max) Instructions: List the activities that you plan to conduct to accomplish your project objective(s) and outcome(s). Provide the indicator(s) you will measure to evaluate project success, a timeline for each activity (e.g., when you expect the activity to occur), and estimate the number of participants you expect to reach. The items listed here should support the project summary documented in SECTION 4.

We recommend following a project timeline of September 2022 – September 2023 for your project activities. Insert additional rows as needed to accommodate all project activities.

SECTION 7: BUDGET NARRATIVE (six pages max) Instructions: You must use the format below. Use the categories and columns that are relevant for your budget request. Be sure to explain how you calculated each cost and the reason each expense is necessary in the Narrative/Justification column. All dollar amounts should be rounded up to the nearest whole dollar.

Reminders:

· Provide cost breakdowns for each line item in the Narrative/Justification column such that the expected cost of each item is listed. For example, the total cost of office supplies should include prices for specific items (e.g., pens, pencils, ink, etc.).

A. Personnel Please use the format provided below to list all staff funding requested. You may insert additional rows as needed.

Note: FTE stands for Full-Time Equivalent, which represents what a person would be paid for full-time employment.

[Insert name and title here], at x% FTE, salary $xx,xxx per year

[insert job duties and responsibilities here]

[Insert name and title here], at x% FTE, salary $xx,xxx per year

[insert job duties and responsibilities here]

Personnel Subtotal

B. Fringe Benefits Provide the Fringe Benefits cost for all personnel listed in Section A. You may insert additional rows as needed.

Organization Fringe Benefit Rate:___________

Personnel fringe benefits

[list benefits covered]

Personnel fringe benefits

[list benefits covered]

Fringe Benefits Subtotal

C. Contractual For all contract work, provide the number of hours the contractor is expected to work as well as the anticipated hourly rate (e.g., # hrs. at $X per hour). Insert additional rows as needed.

[insert service/personnel here]

[provide a justification for why this service is needed; explain rationale for estimated cost]

[insert service/personnel here]

[provide a justification for why this service is needed; explain rationale for estimated cost]

Contractual Subtotal

D. Travel For all travel, include origin and destination information as well as the anticipated dates of travel. Provide justifications for each trip and each person traveling. Enter each trip as a separate line item (e.g., flights to two separate conferences should be two line items: one for flights for Conference 1 and one for Conference 2). Examples for how to report each form of travel are included below. GSA per diem rates can be found here.

Insert additional rows as needed and delete rows that are not applicable to your budget request.

Airfare: round trip name of Airport to and from name of Airport, name of Airline, cost as of date, # people at $XXX per person ($XXX base fare + $XX tax and fees)

Airline checked baggage fee: # bags at $XX per bag

Airport parking: # days x # people at $XX per day

Ground transportation: # days x # people at est. $XX per day

Lodging: out-of-state rate, date, # nights x # people at $XX per day

Lodging tax: out-of-state rate, XX% per day, # nights x # people at $XX.XX per day

Mileage: round trip from place of business to destination, type of transportation, # mi. x # people at $0.XXX per mi.

Per diem (M&IE): out-of-state rate, full day, # days x # people at $XX per day

Per diem (M&IE): out-of-state rate, first & last days of travel, # days x # people at $XX.XX per day

Out-of-State Travel Subtotal

Airfare: round trip name of Airport to and from name of Airport, name of Airline, cost as of date, # people at $XXX per person ($XXX base fare + $XX tax and fees)

Airline checked baggage fee: # bags at $XX per bag

Airport parking: # days x # people at $XX per day

Ground transportation: # days x # people at est. $XX per day

Lodging: in-state rate, date, # days x # people at $X per day

Lodging tax: in-state rate, XX% per day, # days x # people at $XX.XX per day

Mileage: round trip from place of business to destination, type of transportation, # mi. x # people at $0.XXX per mi.

Per diem (M&IE): in-state rate, full day, # days x # people at $XX per day

Per diem (M&IE): in-state rate, first & last days of travel, # days x # people at $XX.XX per day

In-State Travel Subtotal

Combined Out-of-State and In-State Travel Subtotal

E. Materials and Supplies Materials and Supplies are items with a unit cost of less than $5,000. See Section 2.0 of the RFA for restrictions. Requests for supplies must be accompanied by a justification for the need for such items. Insert additional rows as needed. Only one nutrition education reinforcement item will be funded per household for the project.

Food Demo Supplies

[include an itemized list of the supplies requested and prices]

Nutrition Education Materials

[include an itemized list of the supplies requested and prices]

Nutrition Education Reinforcement Items

[include an itemized list of the supplies requested and prices]

[insert item here]

[include an itemized list of the supplies requested and prices]

Materials and Supplies Subtotal

F. Equipment Equipment is non-expendable, tangible personal property with a unit cost of $5,000 or more with a useful life of more than one year. See Section 2.0 of the RFA for restrictions. Requests for equipment must be accompanied by a justification of the need for such items. Insert additional rows as needed.

[insert item here]

[provide a justification for why this item is needed; explain rationale for estimated cost]

[insert item here]

[provide a justification for why this item is needed; explain rationale for estimated cost]

Equipment Subtotal

G. Other Reminder: Costs associated with sub-grantees should not be included when calculating indirect costs.

Public Service radio announcement

[provide a justification for why this item/service is needed; explain rationale for estimated cost]

Postage, Shipping/handling

[provide a justification for why this item/service is needed; explain rationale for estimated cost]

[insert item here]

[provide a justification for why this item/service is needed; explain rationale for estimated cost]

Other Subtotal

H. Totals Total Direct Costs (Section H1): The total direct costs should be the sum of all bolded subtotals listed for Sections A-G. This number represents the total of all costs prior to calculating indirect costs.

Indirect Costs (Section H2): The Indirect Cost Rate should be applied to all appropriate funds as stipulated in your organization’s Indirect Cost Rate Agreement. Be sure to reference the terms of your organization’s Indirect Cost Rate Agreement prior to calculating indirect costs. If you require assistance, please contact your FNS Regional Office or the Grants Officer listed in Section 7.0 of the RFA.

Total Project Cost (Section H3): In Section H3, the value in your Federal Funds Requested should be the sum of the total direct costs (H1) and the total indirect costs (H2).

H1. Total Direct Costs

H2. Indirect Costs

[insert indirect cost rate applied to your budget here and what it does/does not apply to (example: 12.37% applied only to staff salaries and fringe benefits)]

H3. Total Project Cost