• ALASKA MENTAL HEALTH TRUST AUTHORITY MICRO ENTERPRISE GRANT APPLICATION
  • Please thoroughly read the Micro Enterprise Fund Policies and Procedures prior to completing this application.
     
  • If you are requesting $500 - $1,000:

  • You are required to submit this application and this supporting documentation:

    Proof of Mental Health Trust Authority Beneficiary Status

    Documentation of your dollar for dollar match

    If a portion of your match is from DVR: Need proof of DVR approval & signed DVR Release of information form.

    Quotes and Specification sheets for items awarded funds will purchase

    Short Resume

  • If you are requesting $1,001 - $10,000:
  • You are required to submit this application the the following supporting documentation:

    Proof of Mental Health Trust Authority Beneficiary Status

    Documentation of your dollar for dollar match

    If a portion of your match is from DVR: Need proof of DVR approval & signed DVR Release of information form.

    Quotes and Specification sheets for items awarded funds will purchase

    Business Plan including the following:

    description of business,

    operating plan,

    financial management plan,

    feasibility research,

    profit and loss (3 yrs),

    cash flow (3yrs),

    marketing plan.

  • *see policies and procedures for more detailed information. You are responsible for reading the policies and procedures and ensuring your application is complete.
     
  • Contact Information:
  • Larrisa Cummings1-800-243-2199 (Toll Free)
    1-907-264-6279 (Anchorage)
    1-907-891-7312 (Fax)
    lscummings@alaska.edu (Email)
     
    MEGRANT Applications please mail to:UAA Center for Human Development
    c/o UAA Mailroom
    Attn: Larrisa Cummings - Microenterprise
    3211 Providence Dr
    Anchorage, AK 99508
  •  Submit your Application and supporting documents via email, fax, US Postal Service, Fed Ex, or UPS. ALL documents and the completed application MUST be received on or before 12 pm (noon) on the day of the deadline.  
     
    **IMPORTANT**
     
    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen. 
     
    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over. 
     
    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.
     
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  • I certify that I have read and understand the Policies and Procedures of the Alaska Mental Health Trust Authority Microenterprise Grant.
     

    Clicking the link above will download the Policies and Procedures PDF to your computer.
     
     
  • **IMPORTANT**

    Remember to click "Save and Continue" to save your progress.

  • For questions 7- 18 below summarize the information contained in your business plan if applicable. If you reference your business plan rather than summarizing information below your application will be incomplete and not reviewed by the committee. During your summary you may reference page numbers in your business plan if committee members require additional information.
     
  • Use additional page(s) if you need more room. Please include the question number for each question you are adding additional information.
  • **IMPORTANT**

    Remember to click "Save and Continue" to save your progress.

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  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

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  • If YES, it is highly recommended that you contact an expert to help you develop a plan to manage your Social Security Benefits and report Net Earnings from Self-employment.
     
  • Alaska WIPA ProjectLarrisa Cummingslscummings@alaska.edu  
     
  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

  • 16) How will you use the funds you are requesting?

    Please list each vendor only once with the total amount of the costs for that vendor. You do not need to list each item from the same vendor individually. Include documentation for showing all items.

    EXAMPLE:
    Item/Service: Office Supplies
    Vendor: General Store
    Cost + S&H: $47.65
    Vendor Contact: 123 Main Street Anchorage, AK 99503, (907) 555-1212

  • 17) How are you matching the funds requested above?

    **Please note the amount here in question 17 must be greater than or equal to the total amount listed above in question 16.

    ***If DVR/TVR is going to be matching part of your funds, you must also include the approval or promise letter from them.

  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

  • Now, please share with us information about your support team who will help you succeed in your business plan. 
  • 18) Please list the members of your business support team and their roles below.
     
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  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

  • By typing my full name below, I verify the truthfulness and accuracy of all of the information in this application.  Your typed name will count as your digital signature.
     
  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

  • ME Grant Checklist for Applicants

     

    Required Documents for ALL Applications:

     

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  • For items or services requested in question 16, it is required to provide an estimate/quote:

    • Attach/include documentation or specifications from the Vendor for the items/services requested
    • Verify dollar amount for items/services match the documentation precisely
    • DO NOT ROUND AMOUNTS! (List them accurately ie $8.98 NOT $9.00)
    • Vendor Contact information - name, address, phone - local vendors preferred. Make sure vendor will accept a check. Vendors will only be paid by check.
    • Verify the total amount requested is accurate
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  • Match items in question 17

    *If items are 1 year or less from date of purchase: Receipt or bill of sale is acceptable. If more than 1 year old, it is assessed at current market value, not replacement value unless purchased by DVR, TVR, or other partner agency. Must have documentation to show current market value.

    • Provide documentation of value. Receipts - NOT bank or CC statements.
    • Verify that dollar amount listed on the application match documentation.
    • If DVR is funding, include the signed DVR Release of Information  (ROI) and prior approval noted in the signed DVR Individualized Plan for Employment (IPE)
    • Verify total amount is accurate and documents are clearly marked (store/vendor, item, date, amount)
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  • Additional Documentation Required if Requesting $1,001 -­‐ $10,000 you must also include your Business Plan and Financial Spreadsheet with the following information:

    • Description of the business, operating plan, feasibility research, marketing plan etc.
    • Financial Management plan
      • Start-­‐up budget (if a start-­‐up company)
      • Profit and Loss (3 year projections)
      • Cash flow – 3 year (at least 1 year monthly, 2 years quarterly)
      • If this is for expanding a business include financials for previous years in operation (maximum last three years P&L and cash)

    Larrisa Cummings – Grant Administrator lscummings@alaska.edu

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  • **IMPORTANT**

    Click the "Save and Continue" button at the bottom of each page as you move through the application to save your form. You will be directed to sign in with an email address or choose "Skip Create Account" at the bottom of the pop-up screen.

    If you skip creating an account, make sure your email address is spelled correctly in the pop up that shows. You will receive a link to continue your application at that email address. This is the only way your information is saved for you to continue your application without starting over.

    You must use the link sent in your email to access your form again. This is how your application information is kept private for only you.

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