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Contact Information
First Name
Last Name
Title
Email
Phone
Organization Information
Organization Name
Name of your Head Start program as listed on your grant SOA. Any organization or program with any type of Head Start grant is able to apply (i.e. Head Start, Early Head Start, Migrant and Seasonal, Tribal, EHS-CCP)
x
Organization not found? Please
contact membership
to ensure that we have you current membership information.
Organization Mailing Address 1
Note: If you are awarded a grant, the check will be mailed to this address
x
Organization
Address Line 2
City
State
Zip Code
Head Start Region
Please select...
I
II
III
IV
V
VI
VII
VIII
IX
X
XI
XII
Which type of grant do you operate
Head Start
Early Head Start
EHS/Child Care Partnership
Migrant Seasonal
American Indian/Alaska Native
Organization Website
FED ID or TAX ID #
This can be found on your organization's W-9 form.
x
Upload your organization's W-9 Form
What is your program’s (Head Start, Early Head Start, American Indian/Alaska Native, Migrant Seasonal, Child Care Partnerships) funded enrollment (the number of children intended to serve, NOT your program budget amount)?
total for all OHS grants (including Early Head Start, Migrant and Seasonal, Tribal, EHS-CCP, etc.)
x
Do you have an existing garden or green space at your Head Start program?
Yes
No
Have you previously applied for a Gro More Good Garden grant?
Yes
No
Garden Name
Garden Manager First Name
Garden Manager Last Name
Garden Manager
Email
Garden Manager Phone
Garden Site Address 1
Garden Site Address
2
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
Does your organization own the property where your garden/green space is/will be located?
Yes
No
If the property is owned by someone else, do you have permission to build or expand a garden on this property?
Yes
No
1. Provide a brief summary of your garden or green space project. Please include the main objective of the garden, target audiences who will be served, and the need and impact of your garden project. (Limit 500 words)
2. Describe what your organization will build, enhance or change using the grant funds. Please be specific as possible. (Limit 500 words)
3. How will you spend the grant funds? Please provide an estimated itemized budget. If your project requires more funding, how will you secure the additional funds?
4. Please select the groups who will be involved in your garden or green space project.
(Select all that apply.)
Head Start Children
Early Head Start Children
Parents and Family Members
Program Staff
Community Partners
Community Leaders
Local K-12 Schools
Other ECE Programs
Other (please describe)
These are the groups who will be directly involved in your garden project in some way.
x
4a. If you selected "other," please describe:
5. Describe how you will incorporate the garden into the educational objectives of your Head Start classrooms (Limit 300 words)
6. Do you plan to include educational activities for Head Start families and caregivers about gardening and nutrition?
Yes
No
6b. Please describe your plans for educating parents, caregivers, and families members with your garden project.
6c. Our program is located in the following type of climate (select the one that best applies):
Tropical climate - hot and humid, with high average temperatures and abundant precipitation.
Dry climate - hot and dry, with minimal precipitation.
Temperate climate - warm, wet summers and rainy, mild winters.
Continental climate - warm to cool summers and very cold winters.
Polar climate - are very cold, with long winters and short growing seasons.
How will your climate impact your plant selection?
How do you plan to ensure your garden uses water wisely?
How will your garden demonstrate and teach youth about water conservation?
7. Are you requesting grant funds for a new or existing garden or green space project?
Existing
New
8. If possible, please upload up to three photos of your current or future garden site or green space .
Additional
Additional
9. Identify the item in the drop-down menu that best describes the size of your garden or green space project
Please select...
1–5 beds
5–10 beds
10–15 beds
15+ beds
Other
9a. If selected "other" enter the approximate square footage of the garden space.
10. Please select what type of garden(s) or green space you plan to build?
Edible
Sensory
Educational
Therapeutic
Indoor
Pollinator
Other (please specify)
10a. If you selected "other," please describe.
11. What do you plan to grow in your garden or green space?
12. Estimate the number of children who will be directly engaged in and benefit from the garden or green space project.
13. Estimate the number of family and community members who will be directly engaged in and benefit from the garden or green space project.
14. What are the plans for any produce harvested from the garden or green space?
Please select...
All of the harvest will be used in Head Start classrooms
All of the harvest will be donated to Head Start families and/or a local food agency.
A portion of the harvest will be used in Head Start classrooms and and a portion will be donated to Head Start families and/or a local food agency
A portion of the harvest will be donated to Head Start families and/or a local food agency
Other
14a. If selected "other," please describe other plans for any produce harvested from the garden
15. Are you currently working with any community partners to plan for your garden or green space project?
Yes
No
15a. If you selected "yes," please list the community partners you have engaged in planning this project.
16. Identify how your organization plans to take care of the garden or green space and sustain it year after year. List any additional funding or community partner organizations that may support the garden moving forward. (Limit 300 words)
17. Describe your plan to share news and educate the community about the garden or green space. (Limit 300 words)
18. Will you use social media accounts to share your program's progress and successes broadly?
Yes
No
18a. Name of the person who will lead social media sharing and community outreach
18b. Please list your program's social media accounts below:*
Facebook
Instagram
Twitter
19. Is your program director or chief executive officer aware of and in support of this application?
Yes
No
Please attach a very brief statement of support from program leadership which demonstrates their interest in the garden or green space, intention to integrate it with educational programming, and desire to support the success of the garden or green space over time. This can be a Word document, PDF, or email saved as a PDF.
Please verify that the organization agrees to the following grant conditions:
To use the funds only for the designated purpose as described in the grant application and subsequent grant notification letter and not for any other purpose without the National Head Start Association’s (NHSA) prior written approval. To notify NHSA immediately of any change in (a) Organization’s legal or tax status, (b) Organization’s executive or key staff responsible for achieving the grant purposes, (c) Organization’s ability to expand the grant for the intended purpose, and (d) any expenditure from this grant for any purpose other than those for which the grant was intended. To give NHSA reasonable access to the grantee’s files and records for the purpose of making such financial audits, verifications, and investigations as it deems necessary concerning the grant, and to maintain such files and records for a period of at least four years after completion or termination of the project. To not expend any grant funds for any political or lobbying activity or for any purpose other than one specified in section 170(c)(2)(b) of the Code. To return to NHSA any unexpended funds or any portion of the grant that is not used for the purposes specified herein. To allow NHSA to review and approve the content of any proposed publicity concerning this grant prior to its release and to recognize NHSA and The Scotts Miracle-Gro Foundation (the “Foundation”) in all publicity materials related to the funded project or program, as specified in the grant notification letter. To allow NHSA and the Foundation to include information about this grant in periodic public reports, newsletter, news releases, social media postings, and on their respective website. This includes the amount and purpose of the grant, any photographs you have provided, your logo or trademark, and other information and materials about your organization and its activities. To submit a written report summarizing the project promptly following the end of the period during which you are to use all grant funds and to submit any interim reports NHSA may require. Your reports should describe your progress in achieving the purposes of the grant and include a detailed accounting of the use and expenditure of grant funds. To cooperate fully with NHSA to assure that NHSA is able to satisfy all of the requirements of an “expenditure responsibility” grant in accordance with the terms of the Internal Revenue Code and the regulations thereunder. NHSA reserves the right to discontinue, modify or withhold any payments under this grant award or to require a total or partial refund of any grant funds if, in NHSA’s sole discretion, such action is necessary: (a) because you have not fully complied with the terms and conditions of this grant; (b) to protect the purpose and objectives of the grant or NHSA’s charitable activities; or (c) to comply with the requirements of any law or regulation applicable to you, NHSA, the Foundation, or this grant.
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