2024 CDU Funding Opportunity Application

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3/4/2024 MPOX syndemic approach activities only until HIV Funding becomes available again.

Review the current CDU Funding Opportunity guidance on the CDU Prevention webpage is required prior to application submission.

Email *

I have read the current CDU Funding Opportunity Guidelines. *

Yes

Required

County *

Entity Type *

Entity Name *

Primary Contact Name *

Phone Number *

Street Address *

City *

Zip Code *

Proposed Activity *

The cost of dressing rooms, hospitality rooms, or food/beverage rooms, food, beverages, gift cards, and electronic devices is not allowable
You may not use the WDH, CDU, KnoWyo, or W[h]Y PrEP Matters logos, graphics, or language on social media, websites, advertising, or anything else without CDU approval prior to publishing
Other restrictions may apply

Proposed Date(s) of Activity *

Must occur between Jan and July 2024

Type of Activity *

Education, training, conferences, meetings

Harm reduction activities

Linkage to care activities

Outbreak prevention

Outbreak response

Prevention education

Prevention supply distribution

Promotion of prevention, testing, and/or linkage to care

Testing event

Vaccination event

Other:

Required

Focus Population(s) *

Select all that apply

Justice involved

LGBTQ+

MSM

People experiencing or at increased risk for HIV/STI/hepatitis infection

People experiencing homelessness/unstable housing

People who use/inject drugs

Racial & ethnic minorities

Uninsured

Youth/young adults

Required

Estimated Number of People Served *

(ex: county or city population, number at event, number of students, etc.)

Impact Statement *

How will this activity address the need(s) of the population and meet your stated goal?

Measurable goal *

Example: number of people served or attended, number of people tested, percent decreased or increased over specific time period, pre/post survey results, etc.

Total Funding Amount Requested *

Itemized Budget *

Itemized funding for this activity from other sources *

Does your organization have a whistleblower policy in place?
*

Yes

Does the organization have a retention policy in place?
*

Yes

Have any policy or procedures at your organization changed since the last funding opportunity you submitted?
*

Yes

Has your organization had a lawsuit(s) filed against them within the last 5 years (Such as EEO, DBE, contractor suing for payment)? *

Yes

Have any of the staff been arrested, convicted of a felony or are currently under criminal investigation? *

Yes

Does your organization have a conflict of interest policy in place (pursuant to 200 CFR 200.112)?
*

Yes

Does the organization have any violations of Federal criminal law involving fraud, bribery or gratuity violations potentially affecting the Federal award?
*

Yes

Does your organization have a financial management system in place to track and record program expenditures (examples: QuickBooks, Visual Bookkeeper, Peachtree, or a Customer Proprietary System)? *

Yes

Does your organization's accounting system identify the receipts and expenditures of program funds separately for each award?
*

Yes

Does your organization have a time and accounting system to track time and expenditures by cost objective?
*

Yes

Does the organization maintain appropriate internal controls (Reconciliation checks and balances are in place, duties are segregated, the final approval for payment is made by a different individual than the check/warrant signer)?

Yes

Does the organization maintain a detailed capital asset record system, such as inventory counts verified by individuals independent of those in charge of inventory records, a physical inventory taken once every two years and reconciled to detailed capital asset records, and inventory records the contain the following?

·         Description		
·         I.D. number		
·         Acquisition Date		
·         Cost		
·         Federal Percentage		
·         Grant Number		
·         Location		
·         Use and Condition		
·         Disposition Action		
·         Vested Title		
·         Useful Life	

Yes

Comments:

I understand that I must submit the CDU Funding Opportunity Evaluation Form within 30 days after the activity is complete and no later than July 31, 2024. *

Yes

Required

I understand that an invoice and receipt(s) for CDU Funding Opportunities that will be reimbursed must be submitted to the CDU Prevention Program Manager within 30 days of the activity and no later than July 31, 2024. *

Yes

Required

You will receive a copy of your application via email after you click submit, you will need your copy to complete the Funding Opportunity Evaluation Form.

A copy of your responses will be emailed to the address you provided.

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