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Application Requesting American Rescue Plan Act (ARPA) State and Local Fiscal Recovery Funds (SLFRF)

  1. Please check ALL that apply to your organization
  2. Does your proposed service cover a Qualified Census Tract?
  3. Is this organization a registered 501(c)3?
  4. Has this organization experienced a loss of revenue as a direct result of the COVID-19 pandemic?
  5. ***Please attach backup documentation to quantify any reported COVID-19 revenue losses

  6. Acknowledgment

    Applicant acknowledges that a submission for funding in no way guarantees a future award. The availability of ARPA funds will be based solely on the best interests of the City of Carbondale.

  7. Leave This Blank:

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