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pdfThird Round Urban Promise Zones Application MAX Survey
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MAX Survey
Third Round Urban Promise Zones Application
This is the intake platform for third round applications for designation as an Urban Promise Zone.
Paperwork Reduction Act Burden: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless such collection displays a valid OMB control number. The total time required to complete this
application is estimated to average sixty-two (62) hours, including the time to review instructions, gather the data needed, and
complete and review the application. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for
improving this form, please write to: U.S. Department of Housing and Urban Development, Office of Departmental Grants
Management and Oversight, Room 3156, Washington, D.C. 20410.
The application deadline will be as published in the Promise Zone Application Guide available at: http://www.hud.gov/promisezones.
All applications must be received by the application due date at 5:00 PM EST.
Submission and Verification:
Applicants must click the “submit” button at the end of the survey for the application to be considered. An application is considered
submitted only when the upload is complete and the application is date and time stamped by the Max.gov system. If you do not
receive a confirmation of submission by email from Max.gov, your application was not received and will not be considered.
Please note that busy servers, slow processing or upload issues due to large file sizes are not valid reasons for extensions, and only
applications received via Max.gov by the application due date, at 5:00 PM EST, will be considered. For this reason, applicants are
strongly advised to submit at least 24 hours in advance of the due date.
After a submission, Max.gov provides an opportunity to download a copy of submitted information in addition to providing an email
confirmation of submission. The downloadable copy of submitted information contains all text that has been inputed into the survey
and a list of filenames attached to the submission. Please verify that the file names attached to the survey are the correct files.
Receipt of a confirmation email from Max.gov does not indicate that the application contains all of the required information, only that
information has been input to the survey and/or files have been attached, and such information and files have been received.
Applicants are strongly encouraged to review the application guide prior to clicking the “submit” button at the end of the survey, in
order to check that they have included all required information.
If you have any questions about this application or the Promise Zones initiative generally, please email promisezones@hud.gov.
Technical tips for using Max.gov:
To save your progress on a section of the application and work another section, navigate to the desired section of the application.
Your progress will automatically save when you click the “next” button or select another section from the Question Index. To save
your progress and resume the application later, click the “resume later” button at the bottom of the page. A pop-up box will confirm:
“Your responses were successfully saved.” You may exit the page and resume progress later by following the link to your
individualized application, found at the end of your application invitation email. It is recommended that applicants back up their
narrative survey entries in an off-line word processor in case of computer or technical issues.
The spell check function may not work depending on your browser capabilities. Be sure to double check whether the spell check
function is activated and manually spell check, as necessary.
Where character or page limits apply, such limits have been noted in the application.
Although not required, it is strongly recommended that all documents to be attached to the application are uploaded in PDF format
unless otherwise noted.
Questions and Comments
Please email Promisezones@hud.gov with any questions or comments
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Questions or comments may also be directed by postal mail to the Office of the Deputy Assistant Secretary for Economic
Development, U.S. Department of Housing and Urban Development, 451 Seventh Street SW., Room 7136, Washington, DC 20410
ATTN: Third Round Promise Zone selections.
Additional Info:
Please check www.hud.gov/promisezones for continuously updated information including "Office Hours" for technical help,
webinars, and FAQs that may be helpful to applicants during the application period.
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Third Round Promise Zones Application Stage Site MAX Survey
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MAX Survey
Third Round Promise Zones Application Stage Site
Executive Summary
Provide an Executive Summary that describes the Promise Zone Plan, including:
1. A brief description of the needs and assets of the proposed Promise Zone;
2. The goals of the Promise Zone;
3. Activities to achieve goals;
4. The lead applicant’s capacity to achieve results; and
5. How the Promise Zone designation would accelerate or strengthen existing efforts at comprehensive community
revitalization.
2,000 character limit
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MAX Survey
Third Round Urban Promise Zones Application
Abstract Information
*
I give HUD and USDA permission to share information included in this application survey with the public, including: point of contact
information, zone geography and the mapping tool data sheet, any attached photography, and the entire Goals and Activities Template. (All other
application attachments will not be shared.)
Your response to this question will not affect the review process or the application score
Choose one of the following answers
Yes, I give permission
No, I do not give permission
Non-federal organizations including foundations, social investors, researchers, consultants, and networks of professionals and organizations have expressed interest in the work
underway in communities applying for Promise Zone designations. Community stakeholders and other members of the public also request information from time to time.
* Name of Promise Zone:
City/Cities Included
County/Counties Included
State(s) Included
Congressional District(s) Included
*Application Subcategory
Choose one of the following answers
Please choose...
Please refer to the Definitions and Clarifying Information Section of the Third Round Promise Zone Urban Application Guide for more information.
*Lead Applicant Information
Lead Applicant Organization Name
Lead Applicant Organization Address
City, State, Zip Code
*Type of Lead Applicant
Choose one of the following answers
Please choose...
"UGLG" refers to a Unit of General Local Government. See definition. Please refer to the Definitions and Clarifying Information Section of the
Third Round Promise Zone Application Guide for more information about eligible Types of Lead Applicant.
*Lead Applicant Staff Point of Contact Information
Name
Title
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Email Address
Phone Number
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MAX Survey
Third Round Urban Promise Zones Application
Community Eligibility
*
UGLG Leadership Support
Please provide the name(s), title(s), and jurisdiction(s) for all mayors or chief executives of UGLGs that include any geographical area within the
proposed Promise Zone boundary.
Note: "UGLG" refers to a Unit of General Local Government. See definition.
Letter(s) of UGLG leadership support must be uploaded in the Application Attachments section of MAX Survey. For more information on
requirements for UGLG support, please see the Section titled "Application Section II - Eligibility Criteria" in the Third Round Promise Zone
Application Guide.
*
Mapping Tool Data Sheet
Please provide the following information from the Mapping Tool Data Sheet:
Population
Poverty/ELI Rate
Employment Rate
Note: Applicants are required to use the Promise Zone mapping tool to show both the boundary and the poverty levels. The mapping tool
emails this information as a PDF to the applicant. This PDF, in its entirety, must be attached to this application. See the Definitions and
Clarifying Information Section in the Application Guide for more information on the mapping tool.
Within your narrative attachment, please submit a narrative describing the nature and scope of crime in the Promise Zone, highlighting Part 1
Violent Crime data. For more information, please refer to the Section titled "Application Section III - Selection Criteria Need (10 Points)" in the
Application Guide.
Note: Narrative Attachment must be uploaded in the Application Attachments section of MAX Survey.
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MAX Survey
Third Round Urban Promise Zones Application
Goal 1
Promise Zone Initiative Goal
*
Goal 1
Please select the goal area:
Choose one of the following answers
Please choose...
Note: For Goals 1-3, applicants must select from the four Promise Zone Initiative goals: Create Jobs, Increase Economic Activity, Improve Educational Opportunities and
Reduce Violent Crime. In total, applicants must select at least three of the four Promise Zone Initiative goals. Applicants may also select up to three other community goals from
the following list: Increase Access to Quality Affordable Housing, Promote Health and Access to Healthcare, Improve Community Infrastructure and Promote Civic Engagement.
These goal options are available for Goals 4-6 only.
Goal 1: Description
Describe the Promise Zone Goal.
250 character limit
*How many activities will you be reporting for this goal?
Choose one of the following answers
Please choose...
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MAX Survey
Third Round Urban Promise Zones Application
Goal 1: Activities
Activity 1A
Activity 1A:
Please identify and describe an activity or intervention associated with Goal 1: .
250 character limit
Please select 1, and up to 5, relevant policy areas for the proposed activity:
Please select at most 5 answers
Early
Childhood
Family Asset
Building
Commercial
Corridors
Crime
Prevention and
Housing
Development
Intervention
K-12
Entrepreneurship
Adult
Education
Small
Business
Development
Workforce
Development
Private Sector
Investment
Transportation
Homeownership
Broadband
Renter
Assistance
Community
Infrastructure
Community
Policing and
Trust
Public Safety
Capacity
Building
Homelessness
Health
Healthy Food
Access
Strategic
Planning
None of the Above:
Environmental
Health
Resident
Capacity
Building
Reentry
Rationale/Evidence:
Discuss how or why you believe the proposed activity will lead to the achievement of the goal in this specific context.
500 character limit
Implementation Partners:
List the implementation partner organizations for the proposed activity, including roles and responsibilities for each.
500 character limit
Committed Financial Support
List up to 10 firm financial commitments for implementing this activity. For each commitment, select the type of financing in the first column, and
type of funder/source in the second column, from the drop down menus. A new row will appear when dropdown options are selected. If one or
more unneeded rows appear, please disregard and leave them empty. For each row used, in the third column, please type in: The total dollar
amount committed, name of source, start and end date if available, and any other details including activity and recipient.
For example: Financial Commitment 1 | (Grant or Direct Allocation) | (School District) | $50,000; School District 123 General Fund Allocation;
8/1/16 - 7/31/20; Salary for additional school counselor at Neighborhood High School.
Please Select Financing Type
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Please Select Source Type
Please Enter: Total Amount
($), Source Name, Start and
End Date, Any Other Details:
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Please Select Financing Type
Please Select Source Type
Please Enter: Total Amount
($), Source Name, Start and
End Date, Any Other Details:
Financial Commitment 1
Select Support
Select Support
Needed Financial Support
List up to 10 types of financial support that are, or will be needed for implementing this activity. In the first column, for each need, please select the
type of financing needed. The next row will appear when a dropdown option is selected. If one or more unneeded rows appear, please disregard
and leave them empty. In the second column, please type in: The total dollar amount needed, start and end date if available, and any other details
including activity and recipient.
For example: Financial Need 1 | (Grant or Direct Allocation) | $10,000; 8/1/16 - 7/31/18; Funding needed to purchase test preparation materials for
students at Promise Middle School.
Please Enter: Total Amount ($), Source
Please Select Financing Type
Financial Need 1
Select Support
Name, Start and End Date, Any Other
Details:
Committed Non-Financial Support:
List any committed non-financial support for this activity. List the source and type of support, start and end date for each resource and identify the organization receiving
each resource. Type N/A if not applicable.
Non-Financial Support Needed:
List the types of non-financial support needed for implementing this activity. List the type of support, start and end date for each resource and identify the intended
organization receiving each resource. Type N/A if not applicable.
Expected Outcomes and Measurement:
List measures or metrics that will be used to determine whether the activity is leading to the achievement of the goal or any interim outcomes.
500 character limit
Data Collection, Tracking and Sharing:
For top-level tracking of progress of the activity, describe how data will be collected, tracked and shared.
500 character limit
Timeline/Milestones for Implementation:
Briefly describe anticipated timeline and milestones for implementation of this activity. Omit information on needed financial or non-financial support that would be
redundant with information provided above.
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500 character limit
OPTIONAL Federal Regulatory and/or Statuatory Barriers:
Please Note: Responses to this question are voluntary and will not be evaluated in the application review process
Please describe any regulations and/or statutes that create barriers to the implementation of this activity, with citations if possible. Your voluntary response to this question
will help HUD, and agencies across the federal government, with policy development, program administration, and technical assistance.
OPTIONAL Technical Assistance:
Please select any type(s) of technical assistance that might be needed for this activity.
Please Note: Responses to this question are voluntary and will not be evaluated in the application review process
Technical Assistance is broadly defined as answers to questions, extra support, flexibilities, capacity building, and training that can help organizations to meet their goals by overcoming
identified limitations, barriers, and weaknesses. The responses will help HUD, agencies across the federal government, and a wide network of technical assistance providers in efforts to
develop new services and tools and improve responsiveness to local capacity needs. Responses to optional questions will not affect the applicant’s score in the review process, but may
be beneficial to applicants by helping to create new resources, collaborations, and tools open to communities regardless of Promise Zone designation status.
Check any that apply
Community Engagement/Outreach
Direct Technical Assistance for Specific Issues
Data Collection and Evaluation
Research and Best Practices/General Guidance
Grant and Financial Management Resources
Needs Assessment
Training for Partners and Staff
Peer to Peer Learning and Networking
Please describe each type of identified technical assistance** needed for this activity, including roles and deliverables, if any, that federal staff could play on short term
assignments.*
*short term assignments for federal staff should generally be less than one year.
**The provision of any and all technical assistance, delivered directly by federal staff or by other means, is subject to availability within future
appropriations and ability to identify appropriate staff and to deploy them in the requested timeframe. No response to any individual request can be
guaranteed.
Please Note: Responses to this question are voluntary and will not be evaluated in the application review process.
If more than one type of technical assistance is checked in the response above, please describe each, organized by type.
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Third Round Urban Promise Zones Application MAX Survey
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MAX Survey
Third Round Urban Promise Zones Application
Mapping Tool Data Sheet
Attach the entire PDF mapping tool data sheet and map here.
Please upload one file
Upload files
The mapping tool data sheet and map will not count toward the 28-page narrative or 35-page attachment page limits. For more information on the mapping tool
and mapping tool data sheet, please see the Definitions and Clarifying Information Section of the Third Round Promise Zone Application Guide. The mapping tool can
be found at http://www.huduser.org/PZ2013/promiseZone.html.
Letter of UGLG Commitment
Attach a letter(s) that demonstrates the commitment from UGLG leadership, including the mayors or chief executives of the UGLGs represented in the Promise Zone. For
applications across UGLG lines, a commitment must be demonstrated by leadership of all UGLGs involved.
Please upload one file
Upload files
All letters of support count towards the 35-page limit for attachments.
Narrative
Attach the application narrative here.
Narrative should include the most important information for the purposes of Promise Zone selection, including a Promise Zone-specific diagram of the partnership structure.
For more information on the elements of the narrative, please review the Promise Zones Application Guide.
Please upload one file
Upload files
Narrative may not exceed 28-pages (suggested formatting is Calibri font, 12 point, double-spaced, with one inch margins). Any pages beyond this limit will not be
considered or reviewed. Narrative does NOT count against the 35-page attachment limit.
Additional Documentation
Attach additional documentation here. Additional documentation should include:
◾ To scale city map and community level map
◾ Preliminary Memorandum of Understanding (MOU)
Applicants may also include additional materials in Microsoft Word or PDF format as attachments, including any tables, figures, charts, or additional maps. Applicants are
encouraged not to restate commitments made in the MOU in additional Letters of Support.
Please upload one file
Upload files
All additional documentation will count towards the 35-page attachment limit. Any pages beyond this limit will not be considered or reviewed.
Photographs (Optional)
Attach no more than 3 JPEG photographs of neighborhoods, buildings and streets within the proposed Promise Zone.
The submission of photographs will in no way affect the scoring outcome of an application. These photographs may be used in promotional material in association
with the announcement of the third round designees. Do not include images of individuals, as this would require specific release forms from anyone in the image.
Please upload at most 3 files
Upload files
Optional JPEG photographs will not count towards the 35-page limit for attachments.
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| File Type | application/pdf |
| File Title | https://survey.max.gov/index.php/9 |
| Author | H48930 |
| File Modified | 2015-12-07 |
| File Created | 2015-11-16 |