Grant Application Data Summary (GADS) Form

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Grant Application Data Summary (GADS) Form

The Paperwork Reduction Act of 1995: Public reporting burden for this collection of information is estimated to average 1/2 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number.

1. Applicant Name:      			2. State:      
3. EIN (Employer Identification Number as assigned by the Internal Revenue Service):      			4. DUNS Number (Provide Data Universal Numbering System number received from Dun and Bradstreet):      
5. Federal Amount Requested (Provide dollar amount requested for each one year budget period):
Year 1:     		Year 2:     			Year 3:     
6. Choose the proposed project time frame:
12 Months	24 Months			36 Months
7. Applicant Type (Choose ONE that best describes your organization): Federally Recognized Indian Tribe Consortia of Indian Tribes Incorporated Non-Federally Recognized Tribe Incorporated Non-Federally Recognized Tribe and State Recognized Indian Tribes Incorporated Non-Profit Multi-Purpose Community-Based Native American Organization Urban Indian Center National or Regional Incorporated Non-Profit Native American Organization Alaska Native Village or Non-Profit Village Consortia Incorporated Non-Profit Alaska Native Multi-purpose Community Based Organization Non-Profit Alaska Native Regional Corporation/Association in Alaska Non-Profit Native Organization in Alaska Public or Non-Profit Private Agency Serving Native Hawaiians Agency Serving Native Peoples from Guam, American Samoa, or Northern Mariana Islands Tribally Controlled College or University, or Post-Secondary Vocational Institution College or University Located in HI, GU, AS or MP Serving Native Pacific Islanders Non-Profit Alaska Native Community Entity or Tribal Governing Body Other Tribal or Village Organization Tribal Governing Body
8. Partnerships (Collaborations) - Choose all that apply: Other Federal Agencies Community Organizations National/Local Non-Profit Organizations Tribes State or Local Government Private Business Philanthropic Organizations Faith-Based Organizations
9. Projected number of jobs created (Please provide ANA the number of jobs you anticipate creating if you are awarded an ANA grant):      
10. Please choose the competitive area, for which you are applying for funding (SEDS, Environmental, Native Language). Under the competitive area you have chosen, please check only ONE ANA program area of interest that best describes the focus of your project i.e., only ONE check mark per applicant:
Social and Economic Development Strategies (SEDS)
Economic Development Business Development Community Strategic Planning Organizational Capacity Building Subsistence Project Emergency Response Activities Transportation for Elders and Disabled Transportation for Workforce Development International Tourism and Trade Job Training
Social Development Youth Development Strengthening Family Relationship Skills Cultural Preservation Activities Family Violence Prevention Education Development Foster Parent Training Supporting Elders Supporting People with Disabilities
Governance Tribal Government Program Enhancement Management and Leadership Development Information Management Systems Codes and Ordinances Constitutional Reform Operational Planning Tribal Court Systems
Special Initiative: Improving the Well-being of Children: Native American Healthy Marriage Initiative Relationship and Marriage Education for Adults Relationship and Marriage Education for Youth Marriage Enrichment Pre-marital education and marriage skills Relationship Skills Public Advertising Campaigns Research
Environmental Regulatory Enhancement Environmental Assessment Infrastructure Improvement Develop Regulations, Ordinances, or Laws Develop a Technical Program Training Enforcement Energy Assessment Energy Projects for Export Renewable Energy Resources
Native Language Preservation and Maintenance
Category I - Assessment Data Collection Formal Language Assessment Informal Language Assessment
Category II - Planning Develop Long Range Community Goals for Language Develop a Language Strategic Plan
Category III - Project Implementation Establish Intergenerational Program Train Language Teachers Develop Printed Materials to Teach Language Programs to Broadcast Native Language Preservation of Oral Testimony Digitize Materials