This application must be completed by an officer or employee of the organization that is applying for discretionary funding. All requests for funding must be submitted and will only be accepted through the Blackbaud portal. Applications should be accurate and complete. Please keep a copy of the completed application for the organization’s records before it is submitted. All sections of the application are mandatory unless otherwise noted.
The person(s) who complete this application must be authorized by organization, and have a comprehensive understanding of the organization to be able to fully, truthfully and accurately complete the form.
All requests for funding that are submitted to the New York City Council are considered public documents.
WHERE AND WHEN TO SUBMIT THIS APPLICATION:
Applications must be submitted from January 2, 2019 through February 19, 2019. Please be advised that no late applications will be accepted.
Please review the following checklist to ensure you have all the required information to complete the application.
Please direct all questions to email@example.com
Upon completion of the application, there will be a prompt to print, complete and sign necessary documents that need to be uploaded. Please be advised that applications will not be considered finalized/complete without submission of required forms.
Below is a list of information needed in order to ably complete the application. Be sure to have this information handy to ensure a smooth application process.
1. Federal Employer Identification Number (FEIN)
2. New York State Charities Bureau Registration Number
3. Annual Operating budget of Organization requesting funds
4. HHS Accelerator Prequalification Status and Approved Service Areas. Please note, beginning in FY2020 all applicants must register in the Mayor’s Office of Contract Services HHS Accelerator Portal.
5. Documentation concerning Independent Inquiries, Monitorships, Government Investigations, Inquiries or Audits (other than routine annual audit)
6. Staffing Information for the organization
7. Staffing Information for the programming/services
8. Certificate of Incorporation (for those incorporated on or after July 1, 2017)
9. Current list of Board Members and High/Executive Level Employees (as per IRS 990 Part VI §A and Part VII §A)
10. Please note Adobe Reader is required for viewing and printing the PDF (Portable Document Format) documents found at the end of the application. application.
|Organization and Contact Info|
What is the Organization's Current Federal Employment Number (FEIN)
|(FEIN,TIN,EIN) Use the following format: 123456789 (no dash)||611441052 |
Is the organization's FEIN now, or has it in the past, ever been used by any other organization(s)?
If YES please list the name of the organization(s) and time period?
Does the organization now use, or in the past, used an FEIN other than the one provided?
If yes, please enter the past FEIN Number
Is the organization tax exempt under the Internal Revenue Code?
If YES, is the organization's tax exempt status current with the Internal Revenue Service?
Has the organization ever had its tax exempt status revoked?
Please Provide the Organization's Web site
Please provide the administrative Street Address
|30 Third Avenue Suite 842 |
Does the organization share office space, staff, equipment, or expenses with any other organization?
If YES, please name the organization(s) and the nature of the relationship
Has the organization ever applied for Council funding in the past?
If No, you must fill out and attach this form:Supplementary Application Form
|Any organization applying for New York City Council discretionary funding that was Created after July 1, 2017 must complete this form|
Is the organization exempt from registering with the Charities Bureau
If yes, you must fill out and attach this form: Charities Bureau Exemption Form
Please provide the mission/goal statement of the organization.
|Ensure the conservation and preservation of open space in perpetuity, for the benefit of the general public, and act as steward of the open space properties that it owns, establish a community of gardeners in Brooklyn and Queens to: Educate and inspire people of all ages to become successful and environmentally responsible gardeners; Support community involvement in community gardening, and neighborhood beautification and open space enhancement through activities and programs; Promote the interests of community gardens. BQLT's goal is to strengthen BQLT's 36 gardens and 1 affiliate garden owned by government agencies. |
What is the estimated operating budget for the organization's current fiscal year
Does/will the organization apply for Prequalification Status from the Mayor’s Office of Contract Services (MOCS) via the HHS Accelerator portal?
|If your organization receives more than $10,000 in City Council funding, it must be prequalified in HHS Accelerator and complete the Capacity Building Training Requirement. HHS Accelerator can be found here ||Yes|
Organization Primary Contact
|Program Associate |
Organization Budget/Funding Contact Person
|Board Treasurer |
Is the organization seeking funding related to Speaker Initiatives and/or City-Wide Initiatives
Speaker Initiatives and/or City-Wide Initiatives List
|Please choose up to 10|| No Selection / Not Applicable|
A Greener NYC
Parks Equity Initiative
Has any principal, authorized official and/or executive member of the organization ever applied for discretionary funding as a representative of another organization?
|(If yes, please provide year and outcome.)||Former board member Meg Fellerath applied for small grants in 2016 through Brooklyn Greenway Initiative |
If yes, please describe status and outcome.
Does any current principal, employee and/or officer have any felony, misdemeanor and/or administrative charges currently pending?
If yes, please describe status and outcome.
Purpose and Use of Funds
Please provide the name of the program
|Brooklyn Queens Land Trust gardens |
Please describe the specific programming/services to be funded.
|Include a description on how the requested funds will be used.||Funds are requested for 227 St Cambria Heights, Merrick Marsden, and Merrick Marsden II community gardens, all BQLT's properties. Gardens need walkways/pathways to increase accessibility and safety in the gardens. Cambria Heights needs tree pruning. All are in need of soil, garden tools and equipment, as well as garden maintenance. DEP water services are provided for the Merrick Marsden garden, the system needs to be turned on in the spring and off in the fall. BQLT organizes all garden events: A Bike Walk tour, a fall Celebration of Gardens that offers workshops and cultural programming, and an Annual Business meeting. |
When will the program operate
|Please list the times the program services operate||Gardens are open from April through November and the gardens have specific open hours. Gardens are also open for events and meetings. |
Briefly describe the staffing for the program
|BQLT has one staff member, as well as 15 board members including a president, vice president, treasurer, and secretary. All board members - most of them gardeners -- coordinate events with staff for garden groups as well as maintains a database through garden visits of conditions in BQLT's 35 community gardens that it owns in Brooklyn and Queens. Staff manages the office and handles gardeners questions and requests, she also maintains a presence on social media. |
Please describe the community benefit of the program / services that is being considered for funding
|The benefit to the community is: the availability of open space for use by the residents, the ability to grow crops for local consumption, to learn about climate change and community driven sustainability while building community, to partake in arts and cultural programming. BQLT provides a safe space for intergenerational learning while contributing to a healthier community. |
Please provide a description of what the organization does and plans to do that invite the community
|BQLT performs outreach with brochures and flyers at BQLT’s Bike and Walk tours, the Brooklyn Botanic Garden "Making Brooklyn Bloom" conference, the yearly Green Thumb conference, as well as block parties. During the growing season, BQLT organizes monthly meetings in various gardens with neighbors and garden members. BQLT also performs outreach through social media such as Facebook, Instagram, etc. |
Please Provide the address of the location/site where the programming/services are offered.
|During the growing season (April through November), BQLT gardens are open during daylight hours for gardening, meetings, and events. During the winter, BQLT offers monthly garden meetings at its office space and two annual events: a Fall Celebration and an Annual Business meeting. |
Has the organization proposed or similar services in the past?
If yes, briefly describe how long service(s) have been offered.
|Founded in 2004, BQLT is a 501 C (3) non profit organization comprised of a 14 member board of directors, one part time staff person, and 35 gardens. Our gardens cannot be sold or developed and are permanently saved as open spaces. BQLT also manages one affiliate garden owned by the MTA. To promote and strengthen a community of gardeners, BQLT educates residents on environmentally responsible practices while supporting neighborhood beautification and community involvement. |
If no, briefly explain why proposed service/program had not been previously offered; and what qualifications the organization has to start providing these services.
Did the organization receive funding for Fiscal Year 2018
If yes, please describe how the Fiscal Year 2018 funds were utilized.
|(Please respond to each separate allocation your organization received.) ||Funds were used to organize two Jazz concerts in Jamaica, for maintenance, landscaping, and property management (including transportation for site visits) of the 227 St Cambria Heights, Merrick Marsden, and Merrick Marsden II gardens. Funds were also used for staff, BQLT's office and property liability insurance. |
Please list all performance evaluations from federal, state, and city agencies for the last three years
|Include agency, rating and date||BQLT has not had any performance evaluations. |
An organization requesting discretionary funding must itself deliver the programming/services of the funded program. Subcontractors or consultants must only be an ancillary part of the delivery of the programming/services. Does your organization have the capacity to provide the proposed programming/services?
Is/will the program/service be located in, operated by and/or affiliated with a religious/parochial and/or private school?
What estimated percentage of program/service participants also attend the religious/parochial and/or private school?
Please describe what types of outreach and/or advertising is done to invite the community/general public to invite and participate in the programming/services being offered.
|BQLT performs outreach with brochures and flyers at gardening events such as the Brooklyn Botanic Garden Making Brooklyn Bloom conference, the annual Green Thumb conference, as well as block parties. During the growing season, BQLT organizes monthly meetings in various gardens and in the BQLT office during the winter months. |
ELECTED OFFICE/PUBLIC AFFILIATION
Is/was the organization connected in any manner, officially or unofficially, to any elected official? (Please error on the side of disclosure if unsure.)
Was the organization created, founded, expanded and/or directed by any past or current elected official, or any person associated with an elected official; in either an official or an unofficial capacity?
Does the organization have any relationships, partnerships, affiliations and/or associations with any elected officials, and/or political organizations, not including discretionary funding, standard community engagement and/or participartory budgeting?
Please describe any past and/or current roles, duties, responsibilities held by any elected official; including but not limited to Board Member, Consulting, Executive Staff, Managerial Staff, or Advisor (either official or unofficial).
Does the organization share office space (physical locale/address), staff, equipment (including telephones, cell phones, internet/network, and fax services) or expenses with any other community-based organization, business or political organization/entity?
If yes, please describe and list the affiliation of any elelcted officals to the above-mentioned entities
If so, please list the name of the organization, business, elected official, political organization or political campaign, time-period, and amount/value of office space.
Has the office space ever been or currently been provided to the organization, by either donation or payment, by another not-for-profit, business, elected official, political organization and/or political campaign?
Before you resume, please review the discretionary funding policies and procedures .
Have you viewed the discretionary polices?
Do you certify that all statements, answers, information and representations given in the foregoing application and in all the supporting forms and documentation, are true, correct and accurate?
Attachments to upload
Please download the forms from the link below, print them out and sign them.
After signing, please scan them and upload the forms here.
|Certificate of Authorization and Completeness.pdf||Conflict o fInterest Disclosure.pdf||Organizational Affiliation Disclosure.pdf|
Please note that all applicants are required to submit a notarized Certification of Authorization form, and a signed Conflicts of Interest form. The Charities Exemption form and the Supplemental Questionnaire (found in the application) should only be completed as needed.