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FY21 Budget Request for Non-County Agencies

  1. If logged in, you will be able to save your progress of this form. You can find any saved forms under the My Applications drop down in the menu bar at the top of the window, then select Form Center.

  2. Contact Information

  3. Proposed Use of Funds

  4. Access the complete Calvert County Comprehensive Plan 2019 Vision & Goal Areas here (PDF).

  5. 2019 Calvert County Comprehensive Plan Vision Areas*

    Select the category that best represents the program for which you are requesting funds. You can check more than one if you feel they apply.

  6. Describe above

  7. Describe above

  8. Is the tri-county area served?*

  9. Provide statistics on the number of people served in Calvert County, and if tri-county, indicate the numbers for St. Mary’s and Charles counties as well. Please note this is only for data from the program indicated in this request

  10. Calvert

  11. St. Mary's

  12. Charles

  13. Calvert

  14. St. Mary's

  15. Charles

  16. Calvert

  17. St. Mary's

  18. Charles

  19. Projected Performance Measures

  20. Governance

  21. Tax Exempt*

  22. Incorporated as a non-profit*

  23. Financial

  24. 1. Copy of the most recent IRS Form 990 -OR-
    2. Copy of most recent audit/financial review -OR-
    3. Most recent fiscal year profit/loss statement

  25. Upload a detailed program budget, using one of the templates below.

    You only need to complete one of the below templates. They are the same template, just in different file formats for convenience.

  26. Certification*

    I hereby approve the submission and content of this application and agree that any funds awarded pursuant to this application will be subject to review by the County and will be administered in conformity with the purposes stated. I further agree that all financial records will be open and available to County officials upon request.

  27. (Board President)
    Your typed name above will act as your electronic signature for this completed form, please review before submitting to ensure all information is accurate.

  28. Leave This Blank:

  29. This field is not part of the form submission.