Applicant Form

St. Louis County

FY2024 and FY2025 Continuum of Care

Notice of Funding Opportunity (NOFO)

Intent to Apply & Threshold Assessment

All applicants must submit the completed form and requested attachments by Tuesday, August 27, 2024. If you do not submit this application by the deadline, you will not be eligible for funding in the FY2024 and FY2025 CoC NOFO competition. Once you hit submit at the bottom of the page, you will not be able to edit any of the information on this page of the application. Please make sure all of the information you input is complete and correct before hitting submit. Do not use the forward or back button on the browser to navigate the application. Also, see an acronym or term you’re unsure of? Click here to reference our CoC NOFO Key Glossary Terms under 2024 and 2025 NOFO Documents. If you have questions, please email the CoC at CoCHomelessPrograms@StLouisCountyMN.gov). Thank You!

APPLICANT INFORMATION

Name of Agency

Contact Phone

Primary Contact

Contact Email

UEI #

Project Description:

Select whether this application is for a new project(s) or a renewal project(s).

Renewal Projects Only:

Are you interested in reducing your renewal grant for reallocation?

New Projects Only:

Do you currently receive other CoC funds?

Do you currently receive any other HUD funding?

Project Name:

How does this project meet a need in the community or close a gap (maximum 2500 characters)?

0/2500 characters

1. The project component is:

2. Target Population:

Singles #
Families #
Youth #

3. Proposed Start Date:

Proposed End Date:

4. Amount of funding requested (Renewal Projects, please do not exceed the amount approved on HUD's Grant Inventory worksheet): $

If necessary, you can add multiple projects to this application, after entering the initial project information, click the Add Project button to add an additional project to this application.

Coordinated Assessment & Referral:

The applicant does NOT agree to participate in the Coordinated Entry System.
The applicant agrees to participate in the Coordinated Entry System.

CoC Participation

The applicant agrees to participate in CoC meetings.
The applicant agency agrees to provide project level data to the CoC by:
- a) Participating in the annual point-in-time sheltered and unsheltered count;
- b) Submitting program reports to the CoC by requested deadlines;
- c) Participating in an annual CoC Planning, Gaps Analysis and Needs Assessment;
- d) Submitting required LSA, HIC, and GIW reports in a timely manner, and
- e) Giving the Local System Administrator administratrive access to all of your programs reported in the HIC or providing necessary waiver request to CoC and submitting required data in a timely manner.

HMIS

Applicant does NOT currently utilize HMIS and does not intend to, if funded.
Applicant does NOT currently utilize HMIS, but agrees to utilize, if funded.
Applicant currently utilizes HMIS, including the following:
- Unique username and password
- Secure location for equipment
- Locking Screen Savers
- Virus protections with auto updates
- Individual or network firewalls
- Restrictions on access to HMIS via public forums
- Compliance with HMIS policy and procedure manual
- Validation of off-site storage of HMIS data

Services
Please check ALL that apply to your program:

Applicant assures that program will have policies that ensure all children are enrolled in school and connected to appropiate services within the community.
Applicant ensures that case managers will systematically assist clients in completing applications for mainstream benefits.
Applicant ensures that staff will systematically follow up to ensure mainstream benefits are received.
Applicant ensures that transportation assistance is provided to clients to attend mainstream benefit appointments, employment training, or job.
Homeless assistance providers use a single application form for four or more mainstream programs.
Applicant agrees that all participants will come from the streets, emergency shelter, transitional housing (entering as homeless), institution, or place not meant for human habitation.

Chronic Homeless Preference (PSH Projects Only)

Applicant agrees to dedicate beds to Chronic Homeless.
Applicant agrees to give preference to Chronic Homeless when filling vacant units.
Applicant agrees to use Housing First when providing housing.

Annual Progress Report (Renewal Projects Only)

HUD requires that applicants submit an Annual Progress Report (APR)
Applicant submitted an APR for the most recent grant year.
Applicant did NOT submit an APR before the most recent grant year.

Other HUD Requirements

Applicant meets ALL other HUD Requirements.
Applicant does NOT meet ALL other HUD Requirements.
Applicant will provide a 25% minimum cash or in kind match for all funds awarded (excluding the funds under the leasing budget line item).

Are there any outstanding HUD monitoring findings still unresolved?YesNo

If yes, explain 0/2000 characters

Did you have any unspent funds for the most recent HUD CoC grant year?YesNo

If yes, explain 0/2000 characters

Warning HUD will prosecute false claims and statements. Convictions may result in criminal and/or civil penalties (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802).

Authorized Applicant Name (print or type):

Title

AGREEMENT

By submitting this application, I certify and agree that I am the owner or the authorized agent of the owner of the above business and that all information submitted is true and correct to the best of my knowledge. I further agree that false or misleading statements will result in nullifying the grant application and require the immediate return of any allocated grant funds to St. Louis County. Failure to provide proper documentation of the information provided in this application to St. Louis County upon request shall render the grant application incomplete, and will result in the grant being nullified and require that all grant funds received be returned immediately to St. Louis County. I understand the information submitted may be public data, pursuant to the Minnesota Government Data Practices Act. I further understand that St. Louis County may audit the use of the grant funds.

*By providing an email address, you are authorizing St. Louis County to exchange information with you about your application using unencrypted email. This information may include private or nonpublic data. Unencrypted email is not secure. You accept the risk that data may be intercepted by someone other than the intended recipient and understand that St. Louis County is not liable for any damages caused by such interception. Selecting email does not authorize St. Louis County to release private or nonpublic data to anyone other than the recipient unless otherwise allowed by law.

Click to agree

Date: