Funding Request Form
Information Required
Program Name
Program Name missing.
Year(s) Covered
Fiscal Year(s) Covered missing.
Requesting Entity
Requesting Entity missing.
Contact Name
Contact Name missing.
Phone
(###-###-####)
Contact Email
Provide the Program Description and Structure.
Include the region, area of focus, and involved partners/stakeholders in the description.
Provide the Program Description and Structure is required.
Provide a detailed description of the evidence upon which the program is based.
Provide a detailed description of the evidence is required.
What needs are being addressed through this program?
*
Check boxes below.
Please select at least one checkbox to continue.
Prevention
Treatment
Intervention
Incarceration
Supervision
Other (If other, please describe):
Other Description
Describe the Specific, Measurable, Achievable and Agreed, Realistic and Timebound (SMART) Objectives of your project.
SMART is required.
What is the target population?
Target population is required.
What are the desired outcomes and how will this support the OCJJCC’s Mission to reduce juvenile crime and support resocialization?
Desired outcomes is required.
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