#SafeSummerSeries Mini Grant Application

Application Window: July 1, 2026 – July 15, 2026 • Deadline: 4:30 p.m. on July 15, 2026

Funding Category

Select the funding category that applies to your organization.

CATEGORY 1

501(c)(3) Organization — Direct Funding

Grants can be made only to tax-exempt organizations with 501(c)(3) status. If an applicant has a 501(c)(3) determination letter from and is in good standing with the IRS, that applicant can receive funding directly from Safe & Sound Hillsborough. The applicant must have a checking account prior to receiving the first check.

CATEGORY 2

Fiscal Agent Partnership

Organizations without 501(c)(3) status may receive support by partnering with a tax-exempt organization willing to serve as the organization's fiscal sponsor consistent with applicable law. Must indicate via Partnership Letter / Memorandum of Understanding. Fiscal Agent to be signatory on application.

Applicant Agency Information

Appendix A — Agency Information

Agency Legal Name *(As listed on Sunbiz.org)

Main Administrative Address *(May be different than location address)

City *

State *

Zip Code *

Contact Name *

Contact Number *

Contact Email *

Organization Website

CEO / Executive Director *

Program / Project Information

The program or project is a specific initiative or initiative managed by the requesting agency, not the entire agency.
Example of project/program specific initiative: ABC Agency is seeking Community Violence Intervention funding for their "Stop the Violence" project, not for the entire agency.

Program Title *

Address *(Location address)

City *

State *

Zip *

Contact Name *

Contact Number *

Contact Email *

Organization Background & Activities

Organization's Background *

Provide a concise description of the Applicant Agency, including its history, years of operation, general mission statement, and primary services provided.

Programming Activities *

Select the box(es) of the program activities that your program/project applies to. All three Mandatory activities must be selected.

MandatoryCommunity Discussions on Gun Violence Prevention Parenting Classes MandatoryGun Safety Discussions with Law Enforcement Participation Stress Management MandatoryBlight Removal / Neighborhood Beautification Mental Wellness Family Support Other

How will your proposed project address the Category(ies) selected above? *

Example: The counselor will provide anger management and drug education to children, focusing on improving communication and preventing substance abuse, thereby preventing violent crime, building safe neighborhoods and supporting categories.

Program Details & Goals

Program Information *

Provide a program summary or overview of program services to be funded of no less than three (3) sentences.

Program Implementation *

The program's implementation plan should outline the program's goal(s), including Who, What, Where, and When. Listing each goal individually.
Example: Goal 1: ABC Agency will conduct a number of trainings on Crime Prevention to the Community at a minimum of 1 per day during the funding period of June 2026.

Goal 1 *

Goal 2 *

Goal 3 (if applicable)

Goal 4 (if applicable)

Organization Experience & Capacity *

Describe the Applicant's organization's experience in serving a specific population and its capacity to implement the proposed program.

Itemized Budget

Appendix B — Project/Program Budget

Estimate the actual costs of supplies, services, and other costs expected to support the proposed activities. Awards may range up to $2,500.

Organization Name *

EIN *

Budget Item	QTY	Cost per Unit	Total Expense Cost
			$0.00
Total Program Expenses / Total Request:			$0.00

Required Supporting Documents

The following documents must be attached at time of submission to be considered for funding. Any documents not submitted may automatically disqualify the applicant.

These files will be sent to the grant team only. They will not appear in your PDF copy or your confirmation email.

Required Florida Division of Corporations Proof of Filing

📎 Choose file…

Required IRS 501(C)(3) Determination Letter

📎 Choose file…

Required IRS Form W9

📎 Choose file…

Required Letter of Support from a previous funder or organization partner

📎 Choose file…

Accepted formats: PDF, JPG, PNG, DOC, DOCX • Maximum 10 MB per file

Certification by Applicant

Appendix C — Applicant Certification

The person completing this application must have legal authority on behalf of the requesting agency to submit this application and to ensure funds are used for the purposes specified herein to provide the required accounting and reporting of these funds.

I HEREBY CERTIFY:

All information included in this application is accurate.
The applicant is in compliance with Federal Civil Rights laws.
Your organization is not and has never been under investigation or found to be in violation of any federal, state, or local civil rights laws.
No shared benefits will be used for political or personal purposes.
No shared benefits will be used for any purpose that would constitute improper or illegal use under the laws, rules, regulations, or orders of the state or local jurisdiction where the applicant is located or operates.
The Applicant Organization currently possesses a 501(c)(3) or 501(c)(4) designation.
No officer, director, trustee, or fiduciary of the applicant has been:
- Convicted of a felony offense under federal or state law, or
- Convicted of any drug offense.

I certify that I have the appropriate authority on behalf of the requesting agency to submit this application and to ensure funds are used for the purposes specified herein to provide the required accounting and reporting of these funds. I also certify that the assurances provided are true and accurate to the best of my knowledge.

Applicant Agency Name *

Printed Name of Person Authorized to Complete this Application *

Title *

Signature *

Draw your signature below using your mouse, trackpad, or finger on a touch device.

CERTIFICATION OF REQUIRED REPORTING

Please initial each section. By initialing and signing this funding application, the applicant agrees to comply with the following terms and conditions as stipulated.

PERIOD OF PERFORMANCE

APPLICANT shall commence services as soon as practical and reasonable under the circumstances. All program activities must be completed by September 30, 2026, unless said date is extended by Safe & Sound Hillsborough in writing. Any request for an extension of time must be submitted in writing no later than 30 days before the end of the performance period of the award.

Initials *

REPORTS AND DELIVERABLES

APPLICANT will keep clear and accurate records throughout the Program period so that the Safe & Sound Hillsborough may readily evaluate the progress of the services rendered at mutually agreed upon times.

APPLICANT will submit a final report (Attachment III) of activities and expenditures documented by receipts or other financial proof of Program expenditures on the report form to Safe & Sound Hillsborough no later than ninety (90) days at the end of the Program performance period. The APPLICANT shall burden all costs and expenses in generating and delivering such documentation, and the documents shall be provided in a format acceptable to Safe & Sound Hillsborough. Failure to comply with the reporting requirements shall result in the APPLICANT having to return funding.

Initials *

RETURN OF FUNDS

If the APPLICANT fails to perform; or is determined later not to be qualified to receive funding, or if the APPLICANT made untruthful statements within its Request for Funding Application; or fails to provide the necessary reporting documents to Safe & Sound Hillsborough, then all funds disbursed to the APPLICANT shall be returned to Safe & Sound Hillsborough within ten (10) business days of Safe & Sound Hillsborough's written demand for the same, and APPLICANT may be ineligible for any future disbursements.

Initials *

Start your Mini Grant Application

Funding Category

Applicant Agency Information

Program / Project Information

Organization Background & Activities

Program Details & Goals

Itemized Budget

Required Supporting Documents

Certification by Applicant

#SafeAndSoundHillsborough

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