SOI 1260 Attachment 1 - Application Form LOCKED.docx
DOCX document 32 KB Posted
- Attached to
- SOI 1260 NY Kicks
- Solicitation number
- 2136138
- Issued by
- New York
About this file
This is an application form for the NY Kicks Program, a Solicitation of Interest (SOI) administered by the New York State Office of Children & Family Services (OCFS). The program invests in soccer programming and related services for disadvantaged youth in New York communities in response to the FIFA World Cup 2026. Eligible applicants include municipalities, public authorities, and not-for-profit organizations, including youth soccer clubs and leagues. Organizations must complete the multi-section application form, which requests applicant information, identification of service areas within economically distressed census tracts, projected youth beneficiaries across age groups from 0 to 26 years old, and a detailed budget justification. The application deadline is specified in the solicitation's Calendar of Events, with submissions required via email to funding@ocfs.ny.gov. OCFS intends to fund multiple qualified organizations based on established criteria.
Individual awards range from a minimum of $2,000 to a maximum of $10,000 to fund eligible operating expenses including programming, equipment, training, and other needs designed to improve mental health and well-being in children and young adults. Priority consideration is given to applications serving youth in economically distressed areas as determined by metrics including population loss, unemployment rates, employment levels, public assistance receipt, poverty rates, and per capita income. Applicants must have either a New York State Statewide Financial System (SFS) Vendor ID or submit an NYS Substitute Form W-9. The application requires certification by an authorized representative and submission of all required documentation prior to the deadline for responsive consideration.
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Other files
| File | Type | Posted |
|---|---|---|
| SOI 1260 NY Kicks FINAL.pdf |
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Text version
SOI 1260 NY Kicks Attachment 1 – Application and Budget Request Form Section 1: Applicant Information
Organization Name:
Organization Street Address:
Project Contact Name:
Project Contact Phone Number (include area code):
Project Contact Email Address:
| Organization Type |
| Yes |
| No |
| Municipality |
| |_| |
| |_| |
| Public Authority |
| |_| |
| |_| |
| Not-for-Profit Organization, including Youth Soccer Club or League |
| |_| |
| |_| |
Top of Form FEIN (9-Digit Federal Employer Identification Number):
Does your organization have a New York State SFS Vendor ID?
· |_| Yes (enter 10-digit SFS Vendor ID Number):
· |_| No, see below.
If your organization does not have a Statewide Financial System (SFS) Vendor ID Number, then you should complete and include the NYS Substitute Form W-9 with your application submission.
Section 2: Service Area
Priority consideration will be given to applications serving youth in Economically Distressed Areas. Economically Distressed Areas shall be based on metrics such as population loss, unemployment rate compared to the State’s rate, private sector employment rate compared to the State’s rate, percentage of households receiving public assistance, poverty rate, per capital income rate, and other factors considered by Empire State Development (ESD).
Identify the Census Tract in which your service area is located by using the Economically Distressed Area (Census Tract) Map to identify and provide the Economic Distress Level of your service area. Locate your organization street address on the census tract map, click on the corresponding census tract, and enter the census tract number and distress level in the fields below.
Census Tract (enter 11-digit number):
Distress Level:
Section 3: Youth Impact
Identify the number of youth that will benefit from this proposal in the age groupings below. Awardees may be required to submit reports pre and/or post-award regarding the number of youth who benefit from this award.
| Age Group |
| Number of Youth |
| 0-4 Years Old |
| 5-9 Years Old |
| 10-14 Years Old |
| 15-17 Years Old |
| 18-20 Years Old |
| 21-26 Years old |
Section 4: Budget Request
| Budget Item |
| Cost |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| Total Amount Requested: |
| $ |
The Total Amount Requested must be between a minimum of $2,000 and a maximum of $10,000. Refer to the Scope of Work section of the solicitation for information regarding what expenses are eligible or ineligible for reimbursement under this program.
Provide a brief narrative below on how the funds will be utilized. Justification should be clear, specific, and directly linked to the program’s objectives and eligible activities:
Top of Form Section 5: Certification
By signing below, I attest that I have express authority to submit this application and am authorized by law to bind the applicant. I also agree to provide additional information and supporting documentation, if requested by OCFS.
Name
Title
Organization
E-mail Address
Street Address
Phone #
City, State, Zip Fax #
| ____________________________________________________ | _________________ | |
| Signature of Authorized Individual | Date |
Note: This sheet must be completed, signed, and included in your submission.
Section 6: Document Submission
Submit the following documents prior to the Deadline for Submission of Applications, indicated in the solicitation’s Calendar of Events, via email to funding@ocfs.ny.gov:
· Attachment 1 – Application and Budget Request Form (REQUIRED)
· NYS Substitute W-9 Form (if your organization does not have an SFS Vendor ID)
Refer to the How to Respond section of the solicitation for additional information regarding requirements and submission instructions.
File details come from the government source that posted it. Updated .