Welcome to City of High Point Form Center

2. 

4. The American Rescue Plan Act (ARPA) was signed into law on March 11, 2021, and provides $350 billion for eligible state, local, territorial, and Tribal governments to meet pandemic response needs and rebuild a stronger, more equitable economy as the country recovers. The City of High Point has been awarded $22,699,511 in Coronavirus State and Local Fiscal Recovery Funds as part of the American Rescue Plan Act. These federal resources are intended to help bring the pandemic under control and address its economic fallout by strengthening support for vital public services, helping to retain jobs, and providing economic stabilization for households and businesses. 

   The City is currently accepting applications from non-profit agencies for programs/services to be funded with these dollars. Up to $5,847,426 in funds are available for allocation. 

   
   

   Requests should be one-time in nature and showcase program sustainability after the funds have been spent, if applicable. Requests will be evaluated based on the themes from community input sessions held in November 2021, including employment, community programs, housing, education, and infrastructure, as well as the priorities of the Mayor and City Council.

   
   

   The application process will follow the below timeline:

   
   

   March 6 – The application process opens up

   
   

   March 22 – Q&A/workshop (staff available to answer questions on the application process) – 10 am, Council Chambers, High Point City Hall, 211 S Hamilton

   
   

   April 17th – Applications due

   
   

   April/May – Applications reviewed by the Finance Committee

   
   

   May/June – Recommendations for funding presented to High Point City Council

   
   

   To be considered for funding, the following items must be submitted by the above application deadline:

   1. Completed copy of the application
   2. Copy of the current IRS 501(c)3 non-profit status certification letter
   3. A list of the current Board of Directors
   4. A most recent copy of an independently audited financial statement or, if unavailable, a board-approved financial audit statement. 
6. For more information contact:

   Stephen Hawryluk
   The City of High Point | Budget and Performance Manager
   336.883.3296 | Stephen.hawryluk@highpointnc.gov

10. Agency Name*
12. Website*
14. Address*
16. City*
18. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
19. Zip Code*
21. Agency Director*
22. Agency Email Address*
24. Agency Phone Number*
26. Total Agency Budget*
27. Agency Fiscal Year End*
    Agency Fiscal Year End
29. Amount of Funding Requested*
33. Organizational Overview
35. Organization Mission Statement*
37. Please provide an organization overview, including significant services, programs, and activities.*
41. Funding request
43. Describe the program or service proposed, including the specific need it will address and the strategy to address the issue.*
45. Provide the service delivery process, including staffing, timelines, and key activities.*
47. Provide a detailed revenue and expenditure budget for the requested funds.*
49. Has the agency been awarded American Rescue Plan Act (ARPA) funds from other sources? If so, please list the amount and what agency is providing the funds.*
51. Who is the target population for the request and where in the City of High Point will the program/service be provided?*
53. Does this request fund the entire budget for the program/service? If not, how will the remaining funds be acquired?*
55. If a funding award/investment is made by the City, how will the project/program remain sustainable after the one-time funds are spent?*
59. Measuring Success
61. Describe the evaluation tool(s) your agency will use to measure the outcomes and effectiveness of the program/service.*
63. If this is an existing program/service, please provide a three-year history of outcomes achieved and total population served. *
67. Attachments Upload

    Upload any documents you feel necessary to attach to your application. (Board of Directors, audit, etc.)

69. By Submitting this form, I hereby acknowledge that:*

    1. I am authorized to submit this application and the supporting documentation on behalf of my Agency.
    2. This application will not be considered for funding unless all the correct documentation has been submitted with this application.
71. Completed By:*
72. Title:
74. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
76. Electronic Signature*
77. Date*
    Date
Leave This Blank:


79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit Submit and Print

* indicates a required field