Community of Faith and Opportunity Initiative

0503-XXXX

EXP.DATE:

Communities of Faith and Opportunity - Questionnaire

Thank you for your interest in the Centers of Community Prosperity initiative; submitting this information does not guarantee that you will receive a designation. OPPE Staff and USDA Subject Matter Experts will determine the selection of communities. By submitting the requested information, you and your Local Prosperity Council will work with the local USDA liaison to:

• Conduct outreach to community stakeholders about USDA programs during council development and project plan implementation 

• Collaborate with OneUSDA team to support council meetings, site visits, and data collection efforts 

• Develop a strategic or project plan for the community and local prosperity council to implement

• Agree to apply to or engage with at least 3 Federal grant/loan programs or farm services

Your responses will be kept confidential and not disclosed in identifiable form to anyone other than USDA employees or its agents. The information provided will be used only for registration, response and research purposes only.

Be ready to include the following information

-Local Assets

-Engaged Partners (to include Name & Email

-Local Challenges

-Community Quarterback Designation

• By clicking this box, I acknowledge that I have read and agree to the above statements

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Q1 To be considered for designation as a Community of Faith and Opportunity, please respond to the following prompts.  The Community Quarterback functions as an organizer and navigator toward the shared goal of community revitalization. The quarterback works with partners to establish shared metrics, brings together knowledgeable allies and financial resources, and ensures the work of community partners will benefit the entire neighborhood. Who would you designate as your community's quarterback?

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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Q2. List and describe 3-5 local challenges or projects you would like to see addressed. These should be concrete, practical opportunities for partnership or projects that your Local Prosperity Council is interested in moving forward.  (no more than 1,500 characters or approximately 250 words)

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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Q3. Identify and describe local assets and community resources that are being leveraged by the Local Prosperity Council to accomplish its goals. (no more than 1,500 characters or approximately 250 words)

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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Q4. List engaged community partners that have committed to participate in the Local Prosperity Council. Please also include their email address.  If they do not have an email, please leave that field blank.

• Partner 1 ________________________________________________

• Partner 1 Email ________________________________________________

• Partner 2 ________________________________________________

• Partner 2 Email ________________________________________________

• Partner 3 ________________________________________________

• Partner 3 Email ________________________________________________

• Partner 4 ________________________________________________

• Partner 4 Email ________________________________________________

• Partner 5 ________________________________________________

• Partner 5 Email ________________________________________________

• Partner 6 ________________________________________________

• Partner 6 Email ________________________________________________

• Partner 7 ________________________________________________

• Partner 7 Email ________________________________________________

• Partner 8 ________________________________________________

• Partner 8 Email ________________________________________________

• Partner 9 ________________________________________________

• Partner 9 Email ________________________________________________

• Partner 10 ________________________________________________

• Partner 10 Email ________________________________________________

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Q5. Do you have additional partners you'd like to add?

• Yes

• No

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Q6 List additional community partners that have committed to participate in the Local Prosperity Council. Please also include their email address.

• Partner 11 ________________________________________________

• Partner 11 Email ________________________________________________

• Partner 12 ________________________________________________

• Partner 12 Email ________________________________________________

• Partner 13 ________________________________________________

• Partner 13 Email ________________________________________________

• Partner 14 ________________________________________________

• Partner 14 Email ________________________________________________

• Partner 15 ________________________________________________

• Partner 15 Email ________________________________________________

• Partner 16 ________________________________________________

• Partner 16 Email ________________________________________________

• Partner 17 ________________________________________________

• Partner 17 Email ________________________________________________

• Partner 18 ________________________________________________

• Partner 18 Email ________________________________________________

• Partner 19 ________________________________________________

• Partner 19 Email ________________________________________________

• Partner 20 ________________________________________________

• Partner 20 Email ________________________________________________

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Q7 Describe implementation steps that stakeholders in the community have taken to address the challenges independently.  (no more than 1,500 characters or approximately 250 words)

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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End of Block: Block 1

Start of Block: File upload

Q8 Letters of support from participating partners and institutions are optional and can be submitted here. Your information will be reviewed, and a follow up call scheduled to confirm submission. Please submit all documents as PDF's

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Q9 Would you like to upload additional files?

• Yes

• No

End of Block: File upload

Start of Block: About you

Q10 First Name

________________________________________________________________

Q11 Last Name

________________________________________________________________

Q12 Title

________________________________________________________________

Q13 Organization

________________________________________________________________

Q14 City

________________________________________________________________

Q15 State

• Alabama

• Alaska

• Arizona

• Arkansas

• California

• Colorado

• Connecticut

• Delaware

• District of Columbia

• Florida

• Georgia

• Hawaii

• Idaho

• Illinois

• Indiana

• Iowa

• Kansas

• Kentucky

• Louisiana

• Maine

• Maryland

• Massachusetts

• Michigan

• Minnesota

• Mississippi

• Missouri

• Montana

• Nebraska

• Nevada

• New Hampshire

• New Jersey

• New Mexico

• New York

• North Carolina

• North Dakota

• Ohio

• Oklahoma

• Oregon

• Pennsylvania

• Puerto Rico

• Rhode Island

• South Carolina

• South Dakota

• Tennessee

• Texas

• Utah

• Vermont

• Virginia

• Washington

• West Virginia

• Wisconsin

• Wyoming

• I do not reside in the United States

Q16 Is the community you serve a designated Opportunity Zone? The Opportunity Zones incentive is a new community investment tool established by Congress in the Tax Cuts and Jobs Act of 2017 to encourage long-term investments in low-income urban and rural communities nationwide. Please click the link below to check your community status: https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.enterprisecommunity.org%2Fopportunity360%2Fopportunity-zone-eligibility-tool&data=02%7C01%7C%7C0d17dcd742094b0c889d08d78f9754df%7Ced5b36e701ee4ebc867ee03cfa0d4697%7C0%7C0%7C637135752430430712&sdata=GrdiSrVLl%2FVtr%2F5FIq68Sf80krhmromQn2HrsHTKt88%3D&reserved=0"

• Yes

• No

Q17 Email address

________________________________________________________________

Q18 Phone Number

________________________________________________________________

Q19 Organization's Website Address (if applicable)

________________________________________________________________

End of Block: About you

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0503-XXXX. The time required to complete this information collection is estimated to average 0.75 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Information provided and collected under OMB control number 0503-XXXX will be maintained in accordance with the protection and confidentiality as outlined in the Privacy Act, the Freedom of Information Act and the Confidential Information Provisions of Title V, Subtitle A, Public Law 107–347 and other applicable Federal laws. Information collected will be kept confidential and not disclosed in identifiable form to anyone other than USDA employees or its agents. The information provided will be used for registration, response and research purposes only.

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