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Completed applications must be submitted no later than 4:00 p.m. (central) on Friday, April 23, 2021.
Individual who will directing program that would receive COMBAT funding
Please select which of these issues your agency will address.
COMBAT is seeking proposals that focus on hiring youth 13-17 to work in their communities from June 2021 to June 2022.
COMBAT is seeking to fund proposals that will provide essential services for domestic violence and sexual assault survivors, in addition to domestic violence prevention programs that promote healthy relationship skills. A point of emphasis is Trauma Counseling for survivors , their children and any potential witnesses, with counseling made available as immediately as possible following the domestic violence and/or sexual violence occurrence. We will also fund programs that focus on assuring that survivors are fully informed of all resources and services available to them, including counseling, sheltering and victim advocacy.
Describe your proposed Anti-Violence/Anti-Drug Prevention program based on your selected area of focus. If funded, this will be the program description used by COMBAT on our website and publications about our funded programs. Address the purpose, target population, services/activities to be provided and expected outcome of your program.
The purpose of a program is to achieve outcomes. It is driven by audience needs and considerations (for whom). It provides a solution to meet those needs (what we do). It fulfills the organization's mission. It defines audience, activities, services, and outcomes.
Goals are typically broad general statements that describe what the program plans to accomplish. Goals establish the overall direction for and focus of a program. Goals define the scope of what the program should achieve and serve as the foundation for developing program objectives.
What problem or opportunity does the program addresses? Who experiences it?
Check all that apply
If you selected other under "Location Type," specify that location type here.
Include name of commuinity center, school, church, etc. if applicable.
List age, ethnic breakdown, gender, and geographic area to be served. Describe your outreach strategy and how clients will be recruited. If referred from other agency(ies), you must include a letter stating that these agencies are aware that they will be part of a COMBAT project, as an Appendix to your proposal. Failure to provide current proof of referring partner will result in 10-point deduction.
% In This Age Group
% Of Male Clients
% Of Female Clients
Percentage of clients expected to serve from each of these ethnic/racial groups.
(Not Hispanic or Latino)
(Or Other Pacific Islander)
Who are your key partners who will enhance your ability to conduct this project? Describe their role(s) related to the project and expertise as well. You must include a current letter stating that these partners are aware that they will be part of a COMBAT project.
Describe the experience and expertise of key staff (and contract positions) for the proposed project (including experience or training in selected strategies). Identify the person who will be the Coordinator/COMBAT Program contact and other staff. Include job descriptions for each staff or contract person
Other Funding Amount
Number of Other Sources
Maximum 10% of Salaries (Describe Benefits Below)
Other Funding Amoung
Number of Other Services
Jackson County Compliance Report Form completed and signed or existing certificate (if you have one). Download This Form (PDF)
Copy of Paid Jackson County Property tax receipt or current exemption certificate.
Copy of evidence of liability insurance coverage for at least $1 million.
Copy of current IRS Form 990 (within past two fiscal years 2018 or 2019).
Copy of full Certified Financial Audit (within past two fiscal years 2018 or 2019).
Copy of letter indicating current IRS 501(c)(3) tax-exempt status (if applicant is not a governmental agency, e.g., city, school district or court in Jackson County).
Certificate of Good Standing from the Missouri Secretary of State.
List of Staff with titles and copies of certifications
List of Board of Directors
By clicking "Agree," you agree and acknowledge that information and statements provided in this application are, to the best of your knowledge, true and accurate.
By typing your name in the "Signature" box below, you acknowledge that this "electronic signature" is valid and binding upon you to the same force and effect of a traditional handwritten signature.
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