Community Agency Application Information

Application Information

2017 Press Release

Criteria for Ranking Applications - Board of Commissioner Resolution #16-235

Nondiscrimination Requirements

Due date: Applications for 2017 must be postmarked by Monday, August 1st, 2016, 5:00pm deadline

Online applications are highly recommended, however, if this proves difficult please print out a paper copy from the link on the bottom right column.  Should you have any questions feel free to call the Controller's Office at 517-676-7206 or contact us via e-mail at controller@ingham.org.

Becoming a Power of We member is strongly encouraged.  In order to become a member download/save these forms to your computer and complete the Member Information Form and the Organizational Charter and return them to Karika Parker at kparker@ingham.org or via US Mail to Ingham County Health Department, Power of We, Attn:  Karika Parker, 5303 S. Cedar Street, Lansing, Michigan 48910.  Once the forms are received Ms. Parker will contact your organization to schedule a one-on-one conversation about the benefits of participation and opportunities to contribute to the various work groups and committees.  To learn more about the Power of We Consortium visit their website at www.powerofwe.org

REQUIRED DOCUMENTS - It will be helpful if you have these documents available to upload before you begin to fill out the online application (Word, Excel, or PDF formats will all work)
  • Detailed Scope of Work - Click on this link for details related to the scope of work - you will need to create a word document with this information to upload, preferably one page or less
  • Copy of current year Organization's Budget
  • Copy of most recent Financial Statement:  Federal 990 Form or Certified Audit. (Please send either the 990 Form or Certified Audit – not both)
  • Current list of Board of Directors
  • Copy of Commercial General Liability Insurance.  Commercial General Liability Insurance on an “occurrence basis” only with limits of liability of not less than ONE MILLION AND NO/100 DOLLARS ($1,000,000) per occurrence and/or aggregate combined single limit, personal injury, bodily injury and property damage.  Coverage shall include the following:  (1) Broad Form General Liability Endorsement or equivalent if not in policy proper; (2) Contractual Liability; (3) Products and Completed Operations; and (4) Independent Contractors coverage.
How to Apply:
  • Online Application Form
    • Enter information about your organization and project budget - it is recommended that you print out a paper form from the link below before you begin so you may compose and edit  your answers before filling out the online form - you may compose your answers in Word and cut and paste them into the appropriate box in the online form
    • Upload required documents listed above - All formats of files are accepted (example: pdf, word, excel)
    • Any information that does not fit in the amount of room given on the application can be uploaded as an "other" document or e-mailed to controller@ingham.org
    • When you are finished with your online application you will be asked to review the application before continuing to the last step
    • At this time you may print a copy for your records
    • The last step will be uploading the required documentation
  • Paper Form - Click on this link to print a copy of the application - the application must be submitted in a typewritten format
    • Mail - Send to Ingham County Controller's Office, Ingham County Courthouse, Room 101-A, 341 S Jefferson St., P.O. Box 319, Mason, Michigan, 48854; or
    • Email application and required documentation to controller@ingham.org