General Applicant Information.docx

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Drug-Free Communities (DFC) Support Program - NEW (Year 1)
Opportunity number
CDC-RFA-CE-26-0061
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This document is a template for general applicant information required for the Drug-Free Communities (DFC) Support Program grant application. Applicants must provide contact information and organizational details for three key personnel positions: the Authorized Organization Representative (AOR), the Program Director/Principal Investigator (PD/PI), and the Project Coordinator. Each personnel entry requires name, title, physical address, city/state/ZIP code, phone number, and email address. Additionally, applicants must submit the coalition's mission statement focused on prevention and reduction of youth substance use, identify the specific substances of use by youth addressed in the application, and document the coalition's establishment date and all ZIP codes served.

The template also requires applicants to provide community demographic and operational information, including population size, median income of the service area, and confirmation of whether the coalition serves a federally recognized tribal area. Applicants must disclose any geographic overlap with other DFC-funded coalitions and, if overlap exists, submit a Letter of Mutual Cooperation. For coalitions serving tribal areas, applicants must confirm representation from the Bureau of Indian Affairs, Indian Health Service, or a tribal government agency with substance use expertise. Finally, applicants must provide their System for Award Management (SAM) registration date, with active registration required for application eligibility.

General Applicant Information.docx

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cdc-rfa-ce-26-0061_v8.pdf PDF

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General Applicant Information You must provide responses to the required information below.

KEY PERSONNEL

IInformation Required
Response

1. Authorized Organization Representative (AOR) Name/Title Address (No P.O. Boxes) City/State/ZIP Phone Number E-mail Address

2. Program Director/Principal Investigator (PD/PI) Name/Title Address (No P.O. Boxes) City/State/ZIP Phone Number E-mail Address

3. Project Coordinator Name/Title Address (No P.O. Boxes) City/State/ZIP Phone Number E-mail Address

STATUTORY REQUIREMENTS

4. Mission Statement: Provide the coalition’s Mission Statement. The mission statement must focus on the prevention and reduction of youth substance use in the community served.

5. List the substances of use by youth addressed in this application.

COALITION AND COMMUNITY INFORMATION

6. What is the date that the Coalition was established?

Provide month, day, and year.

7. List all ZIP codes served by the coalition. (Look up a ZIP code at USPS.com.)

8. Do any of the ZIP codes served by your coalition overlap with those of other DFC-funded coalitions? If yes, provide a Letter of Mutual Cooperation.

9. What is the population size of the community served by the coalition?

10. What is the median income in the community the coalition intends to serve?

11. Does the coalition serve a federally recognized tribal area?

12. Does the coalition have representation from the Bureau of Indian Affairs, the Indian Health Service, or a tribal government agency with expertise in the field of substance use?

13. Enter your SAM registration date.

Failure to have an active registration will make your application ineligible.

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