oppHRSA-18-006-cfda93.124-cidHRSA-18-006.pdf

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Submission D:20061219143208- 05'00' D:20061219143305- 05'00' Grant Application Package Grants.gov Grant Application Package Grants.gov CFDA Number:

Opportunity Title:

Offering Agency:

Agency Contact:

Opportunity Open Date:

Opportunity Close Date:

CFDA Description:

Opportunity Number:

Competition ID:

Application Filing Name:

Select Forms to Complete Mandatory Optional Instructions About the Application Package.

· This application package is used to apply for the specific Federal funding opportunity referenced in this application package. Please verify that you have downloaded and completed the application package for the correct funding opportunity announcement.

· This application can be completed in its entirety offline using Adobe Reader.

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Using the Application Package.

· The application package is a compilation of forms, such as the SF-424, budget forms, attachment forms, and narratives.

· It is recommended that the SF-424 cover page be the first form completed for the application package. Some data entered on the SF-424 cover page will pre-populate data fields in other subsequent forms in the application package.

· Forms identified as Mandatory are required to be filled out to successfully submit your grant application at a minimum. Optional Forms are used to provide additional support for this application or may be required for specific types of grant activity. Reference the application package instructions for more information regarding Optional Forms.

· Select the check box next to the form's name to add the form to the application package. To navigate to the form in the application package, click on the underlined form name. To remove a form from the application package, uncheck the box next to the form name.

· When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid or incomplete information in a field, you will receive an error message.

· Your application will be rejected if you do not follow the Agency and Grants.gov guidance on file naming conventions. Please review the application instructions for this Opportunity Package for specific guidelines and refer to FAQs in the Grants.gov Applicants tab.

Submitting the Application Package.

· You can save the application as you work on it by clicking on the "Save" button.

· Click on the "Check Package for Errors" button to ensure that you have completed all required data fields. Correct any errors. If no errors are found, save the application package. The "Save & Submit" button will also become active.

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· Click on the "Save & Submit" button to begin the application submission process. (You must be connected to the Internet at this time.) You will be taken to the applicant login page to enter your Grants.gov username and password. Follow all onscreen instructions for submission. Upon submission, you will be provided with a Grants.gov Tracking Number.

· You will receive a series of emails after submission: 1. Successful transmission to Grants.gov and your application is undergoing a series of system checks, 2. An email either indicating specific errors in your application OR an email indicating that your submission is being prepared for agency download, and 3. Your application has been retrieved from Grants.gov by the funding agency for further review only after the agency acknowledges the download. If you receive an email with an error, please correct your application and resubmit.

Additional Application Package Information.

· Additional instructions and FAQs about the Application Package can be found in the Grants.gov Applicants tab.

This electronic grants application is intended to be used to apply for the specific Federal funding opportunity referenced here.

If the Federal funding opportunity listed is not the opportunity for which you want to apply, close this application package by clicking on the "Cancel" button at the top of this screen. You will then need to locate the correct Federal funding opportunity, download its application and then apply.

Name- Version Form Tag Name Mandatory Name- Version Form Tag Name Optional Name- Version Form Tag Name SelectedOptional Name- Version Form Tag Name SelectedMandatory Grant Application Package Grants.gov Grant Application Package Grants.gov

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http://www.grants.gov/web/grants/applicants/applicant-faqs.html Also the Grants.gov Contact Center is available for further assistance. The Contact Center is available 24 hours a day, 7 days a week excluding federal holidays.

Email: support@grants.gov Phone: 1-800-518-4726 (local toll free). For international callers, please dial 1-606-545-5035 to speak with a Contact Center representative.

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To download the Grants.gov required version visit:

http://www.grants.gov/web/grants/applicants/adobe-software-compatibility.html For more information:

http://www.grants.gov/web/grants/applicants/applicant-faqs.html Also the Grants.gov Contact Center is available for further assistance. The Contact Center is available 24 hours a day, 7 days a week excluding federal holidays.

Email: support@grants.gov Phone: 1-800-518-4726 (local toll free). For international callers, please dial 1-606-545-5035 to speak with a Contact Center representative.

State Application Identifier Applicant Identifier

1. TYPE OF SUBMISSION

4. a. Federal Identifier

5. APPLICANT INFORMATION

Organizational DUNS:

Legal Name:

Department:

Division:

Street1:

Street2:

City:

State:

ZIP / Postal Code:

Country:

Person to be contacted on matters involving this application First Name:

Middle Name:

Last Name:

Suffix:

Phone Number:

Fax Number:

Email:

6. EMPLOYER IDENTIFICATION (EIN) or (TIN):

7. TYPE OF APPLICANT:

Other (Specify):

Women Owned Socially and Economically Disadvantaged Small Business Organization Type If Revision, mark appropriate box(es).

9. NAME OF FEDERAL AGENCY:

A. Increase Award B. Decrease Award C. Increase Duration D. Decrease Duration E. Other (specify):

10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER:

Is this application being submitted to other agencies?

TITLE:

11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:

2. DATE SUBMITTED

3. DATE RECEIVED BY STATE

APPLICATION FOR FEDERAL ASSISTANCESF 424 (R&R)

County / Parish:

Province:

Prefix:

What other Agencies?

TYPE OF SUBMISSION is required: If this submission is to change or correct a previously submitted "New", "Resubmission", "Renewal", "Continuation", or "Revision" application, click the Changed/Corrected Application box and enter the Grants.gov tracking number in the Previous Grants.gov Tracking ID field. Unless requested by the agency, applicants may not use this to submit changes after the closing date.

Is this application being submitted to other agencies: Check box if applicable.

This field is required.

Is this application being submitted to other agencies is required.

8. TYPE OF APPLICATION:

OMB Number: 4040-0001 Expiration Date: 10/31/2019

b. Agency Routing Identifier

12. PROPOSED PROJECT:

Start Date Ending Date

13. CONGRESSIONAL DISTRICT OF APPLICANT

c. Previous Grants.gov Tracking ID Country:

Position/Title:

Province:

County / Parish:

State:

City:

Street2:

Street1:

ZIP / Postal Code:

APPLICATION FOR FEDERAL ASSISTANCE

SF 424 (R&R)

15. ESTIMATED PROJECT FUNDING

a. Total Federal Funds Requested

17. By signing this application, I certify (1) to the statements contained in the list of certifications* and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances * and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious. or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001)

19. Authorized Representative First Name:

Middle Name:

Last Name:

Suffix:

Position/Title:

Organization:

Department:

Division:

Street1:

Street2:

City:

State:

ZIP / Postal Code:

Country:

Phone Number:

Fax Number:

Email:

Signature of Authorized Representative Date Signed

20. Pre-application *The list of certifications and assurances, or an Internet site where you may obtain this list, is contained in the announcement or agency specific instructions.

County / Parish:

c. Total Federal & Non-Federal Funds

18. SFLLL (Disclosure of Lobbying Activities) or other Explanatory Documentation Province:

b. Total Non-Federal Funds Prefix:

First Name:

Middle Name:

Last Name:

Suffix:

Position/Title:

Organization Name:

Department:

Division:

Street1:

Street2:

City:

ZIP / Postal Code:

Country:

Phone Number:

Fax Number:

Email:

State:

County / Parish:

Province:

Prefix:

16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS?

DATE:

THIS PREAPPLICATION/APPLICATION WAS MADE

AVAILABLE TO THE STATE EXECUTIVE ORDER 12372

PROCESS FOR REVIEW ON:

PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW

PROGRAM IS NOT COVERED BY E.O. 12372; OR

d. Estimated Program Income

21. Cover Letter Attachment

14. PROJECT DIRECTOR/PRINCIPAL INVESTIGATOR CONTACT INFORMATION

1.

OMB Number: 4040-0007 Expiration Date: 01/31/2019

ASSURANCES - NON-CONSTRUCTION PROGRAMS

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND

IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.

NOTE:

Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified.

As the duly authorized representative of the applicant, I certify that the applicant:

Has the legal authority to apply for Federal assistance and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management and completion of the project described in this application.

Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee- 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and, (j) the requirements of any other nondiscrimination statute(s) which may apply to the application.

2.

Will give the awarding agency, the Comptroller General of the United States and, if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.

3.

Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.

4.

Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.

5.

Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).

6.

Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to:

(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.§§1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Previous Edition Usable Standard Form 424B (Rev. 7-97)Prescribed by OMB Circular A-102 Authorized for Local Reproduction 7.

Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally-assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases.

8.

Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.

Standard Form 424B (Rev. 7-97) Back 9.

12.

Will comply, as applicable, with the provisions of the Davis- Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333), regarding labor standards for federally-assisted construction subagreements.

Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system.

10.

Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more.

11.

Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93- 205).

13.

Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593(identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et seq.).

14.

Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance.

15.

Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.

16.

Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead-based paint in construction or rehabilitation of residence structures.

17.

Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations."

18.

Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program.

SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL

TITLE

DATE SUBMITTED

APPLICANT ORGANIZATION

Will comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award recipients or a sub-recipient from (1) Engaging in severe forms of trafficking in persons during the period of time that the award is in effect (2) Procuring a commercial sex act during the period of time that the award is in effect or (3) Using forced labor in the performance of the award or subawards under the award.

19.

OMB Approval No: 0915-0374Expiration Date: 03/31/2020 NAT Program Specific Data Forms Fields marked with an asterisk (*) are required

NURSE ANESTHETIST TRAINEESHIP

* Current Fiscal Year:

(Select the fiscal year date that is provided in the current NAT Funding Opportunity Announcement cover page) Table 1 - NAT: Enrollment, Traineeship Support, Graduates, Graduates Supported and Projected Data Students # Masters Students # Doctoral Students

GRAND TOTAL

Practice Settings Number of Graduates Community Health Centers Migrant Health Centers Health Care for the Homeless Grantees National Health Service Corps Sites Indian Health Service Sites/ Tribal Health Sites Federally Qualified Health Centers State or Local Health Departments Ambulatory Practice Sites Designated by State Governors Health Professional Shortage Areas (HPSAs) Rural Populations/Settings Underserved Populations/Settings

3. Percentage of Graduates Employed in these Settings (SFP) (Number 1 divided by Number 2) Project/Performance Site Location(s) OMB Number: 4040-0010 Expiration Date: 10/31/2019 Project/Performance Site Primary Location I am submitting an application as an individual, and not on behalf of a company, state, local or tribal government, academia, or other type of organization.

Organization Name:

DUNS Number:

* Street1:

Street2:

* City:

County:

* State:

Province:

* Country:

* ZIP / Postal Code:

* Project/ Performance Site Congressional District:

Project/Performance Site Location I am submitting an application as an individual, and not on behalf of a company, state, local or tribal government, academia, or other type of organization.

Organization Name:

DUNS Number:

* Street1:

Street2:

* City:

County:

* State:

Province:

* Country:

* ZIP / Postal Code:

* Project/ Performance Site Congressional District:

Additional Location(s) Project/Performance Site Location(s)

1. Are Human Subjects Involved?

IRB Approval Date:

Human Subject Assurance Number:

2. Are Vertebrate Animals Used?

IACUC Approval Date:

Animal Welfare Assurance Number:

4.b. If yes, please explain:

4.c. If this project has an actual or potential impact on the environment, has an exemption been authorized or an environmental assessment (EA) or environmental impact statement (EIS) been performed?

4.d. If yes, please explain:

6. Does this project involve activities outside of the United States or partnerships with international collaborators?

6.b. Optional Explanation:

7. Project Summary/Abstract

11. Equipment

8. Project Narrative

12. Other Attachments RESEARCH & RELATED Other Project Information Is the IACUC review Pending?

If no, is the IRB review Pending?

2.a.

If YES to Vertebrate Animals

3. Is proprietary/privileged information included in the application?

4.a. Does this Project Have an Actual or Potential Impact - positive or negative - on the environment?

6.a. If yes, identify countries:

9. Bibliography & References Cited

10. Facilities & Other Resources Are Human Subjects Involved is required.

Are Human Subject Involved: If activities involving human subjects are planned at any time during the proposed project at any performance site. Check yes even if the proposed project is exempt from Regulations for the Protection of Human Subjects. If no, skip the rest of block 1.

This field is required.

1.a.

If YES to Human Subjects Is the Project Exempt from Federal regulations is required.

Is the Project Exempt from Federal regulations?

Is the IRB review Pending is required.

Is the IRB review Pending?

If yes, check appropriate exemption number.

Are Vertebrate Animals Used is required.

Are Vertebrate Animals Used? If activities involving vertebrate animals are planned at any time during the proposed project at any performance site, check yes. If no, skip the rest of block 2.

Is the IACUC review Pending is required.

Is the IACUC review Pending? Indicate if an Institutional Animal Care and Use Committee (IACUC) review is pending.

Is proprietary/privileged information included in the application is required.

Is proprietary/privileged information included in the application: Patentable ideas, trade secrets, privileged or confidential commercial or financial information, disclosure of which may harm the applicant, should be included in applications only when such information is necessary to convey an understanding of the proposed project. If the application includes such information, check yes and clearly mark each line or paragraph on the pages containing the proprietary/privileged information with a legend similar to: "The following contains proprietary/privileged information that (name of applicant) requests not be released to persons outside the Government, except for purposes of review and evaluation." This field is required.

Does this project have an actual or potential impact - positive or negative - on the environment is required.

Does this project have an actual or potential impact on the environment: Indicate if this project has an actual or potential impact on the environment? This field is required.

If this project has an actual or potential impact on the environment, has an exemption been authorized or an environmental assessment (EA) or environmental impact statement (EIS) been performed? - Check yes or no.

Does this project involve activities outside of the United States or partnerships with international collaborators is required.

Does this project involve activities outside of the United States or partnerships with international collaborators? Indicate whether this project involve activities outside of the United States or partnerships with international collaborators. This field is required.

Form Attachments:

Is the Project Exempt from Federal regulations?

5. Is the research performance site designated, or eligible to be designated, as a historic place?

Is the research performance site designated, or eligible to be designated, as a historic place is required.

Is the research performance site designated, or eligible to be designated, as a historic place?: If any research performance site is designated or eligible to be designated as a historic place, if Yes, check the Yes box and then provide an explanation in the box provided in 5.a. Otherwise, check the No box.

5.a. If yes, please explain:

OMB Number: 4040-0001 Expiration Date: 10/31/2019 Enter the Zip Code (or ZIP+4) of the Lobbying Registrant City of the Lobbying Registrant.

Enter the second line of street address for the Lobbying Registrant Enter the first line of street address for the Lobbying Registrant.

Enter the Zip Code (or ZIP+4) of the Lobbying Registrant City of the Lobbying Registrant.

Enter the second line of street address for the Lobbying Registrant Enter the first line of street address for the Lobbying Registrant.

10. a. Name and Address of Lobbying Registrant:

9. Award Amount, if known:$

* Street 1

* City State Zip Street 2

* Last Name Prefix

* First Name Middle Name Suffix

DISCLOSURE OF LOBBYING ACTIVITIES

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 Approved by OMB 0348-0046

1. * Type of Federal Action:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Type of Federal Action is required: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. * Status of Federal Action:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action is required: Identify the status of the covered Federal action.

3. * Report Type:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

For Material Change Only:

year quarter date of last report

4. Name and Address of Reporting Entity:

Reporting Entity: Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. This field is required.

Reporting Entity is required: Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

Tier if known:

* Name

* Street 1 Street 2

* City State Zip Congressional District, if known:

Congressional District, if known:

* Name

* City State

* Street 1 Street 2 Zip

6. * Federal Department/Agency:

7. * Federal Program Name/Description:

CFDA Number, if applicable:

8. Federal Action Number, if known:

b. Individual Performing Services (including address if different from No. 10a) Prefix

* First Name Middle Name

* Street 1

* City State Zip Street 2 11.

* Last Name Suffix Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

* Signature:

*Name:

Prefix

* First Name Middle Name

* Last Name Suffix Title:

Telephone No.:

Date:

Federal Use Only:

Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)

If Small Business is selected as Type of Applicant, then note if the organization is Woman-owned and/or Socially and Economically Disadvantaged.

This field is required.:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

TYPE OF APPLICATION - New: Select the type from the following list. Check only one:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

TYPE OF APPLICATION - Resubmission: Select the type from the following list. Check only one:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

TYPE OF APPLICATION - Renewal: Select the type from the following list. Check only one:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

TYPE OF APPLICATION - Continuation: Select the type from the following list. Check only one:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

TYPE OF APPLICATION - Revision: Select the type from the following list. Check only one:

New: An application that is being submitted to an agency for the first time.

Resubmission: An application that has been previously submitted, but was not funded, and is being resubmitted for new consideration.

Renewal: An application requesting additional funding for a period subsequent to that provided by a current award. A renewal application competes with all other applications and must be developed as fully as though the applicant is applying for the first time.

Continuation: A non-competing application for an additional funding/budget period within a previously approved project period.

Revision: An application that proposes a change in: 1) the Federal Government's financial obligations or contingent liability from an existing obligation; or, 2) any other change in the terms and conditions of the existing award.

This field is required.:

A. Increase Award May select more than one.:

If a revision mark the appropriate box(es):

B. Decrease Award May select more than one.:

If a revision mark the appropriate box(es):

C. Increase Duration May select more than one.:

If a revision mark the appropriate box(es):

D. Decrease Duration May select more than one.:

If a revision mark the appropriate box(es):

E. Other If "Other" is selected, please specify in text box provided.:

Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district.

If outside the US, enter 00-000.

To locate your congressional district, visit the Grants.gov web site

This field is required.:

If no, check appropriate box. This field is required.:

IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS: If yes, check box.