Exhibit CC 06-06-2016 Item No. 16 Additional Follow-up - FY 2016-17 Final Bdget SessionGrant Application Page I of 3
Send To Printer
Administration Page
Grant Application
Cc &/0/!b
·~JG
Contact Information
Mell ~Y·
Full Legal Organization Name: Iranian Federated Women's Club
Street Address:
City: Cupertino State: CA Zip Code: 95014
Organization Website: www.payvand .org
Organization President I Fariba Neja!
Executive Director:
Title : President
PHone Number:
Contact Person: Monica Padilla
Title : Secretary
PH one Number:
Organization Information
501 (c)(3)?: Yes
Fiscal Sponsor Name : Iranian Federated Women 's Club
Fiscal Sponsor Address:
Total Organization Budget: $15000 .00
Total# of Staff: o
Organizational Mission
Statements :
The ·~jve of this
Email :
Email :
Year Established : 1996
Total# Board Members : 11
Total# of Volunteers : 30
:?,'3.v .::i_n,~:~JL(-:inL in ar~as ·-~;f q.:::ne.r-a.1 .. 3n,) T.Lan .i..an Cl_J:l.tu_r;:: ,3no
r~;r.-lucaticri . -lFVJC i~3 a SGl {:_~") (·:;; riot for prof.:t
' . . ' . . . ~ . . . ~ organ1zac10n ana a0es nGc engage in any p0i1c1ca1 0r
religious activity and will net be affiliated wi~n any
.! .. 1.::~ .i. :1
Brief Description of ·The Jce;n:ar, F';:,derat::ed Vicmer,':~ C:.Lub is a. ".F':rnber cf' t::he
Organization: Lema f;rir.::t.:t Distri..:..:t , CalifcrnJ_a F(::--Jr:::r~.i.tr.::cJ ~"i(Jrncn ' ,<:; C:l _1b
Brief Description of Services
Provided:
and t::he General federated Women 's Club . The Iranian
F';:·'.,jc-r:·at.c•ci v;Jcr!r.·:·:r,,'::._~ : .. -~.1.1.~L, :rs Lh-::~ .·~:c:L.·~! c:~ .... :iy .... t:_; ...... ;._f;.CJ
:.:L-;·:~ : .. ;..; t.}·!.d __ ,,_,,,A,._-1 ·Yi.: rr L·,~<1~<1: f :cr:1 Lh-:·~ .~.t·:~~-~;·~.u r··t.:. ~~o/fc.c
G-: =:! .~~.n ·i. ;:; .::1. t i. (~,n s . =,)u :· qr t:.l rt ts .. ~1 n U ::; pun.:::: u r::: cf ,~; :_~ (:~r:. t: s ;3 _n.d
L!·-~-i,::,r~1-:· ;·],·) r·~r;T r :Ynnr·~t-•. :~ ~:~n··/ ~-r.: .. =: r;1 ()1~·::: n1.· n-:-)1it-.~~--:,:~1
httn ·//fn1·n1 <eLI. f"'llnPrtinn nrrr /rr r"1nt /"1 rlrnin nnn11n "1<en v?GA Tri =() f)/f../'/()1 f..
Grant Application
L~~-·:1-:k:s , 3cf1c~La tE.>h :i.:ps 1 E~:..:~L , usiri.q rnu1.t-i rncd:~ . .::. .;.:_!.:.
(:(;r~rrnun.i cat i en ~::.n.d h·alpi n~ -.)r. ur:.:.is-r .:~ t:'. 3L _·1i rv; th.::-r:e:,.,;
c·n:·Jnt··T' . .'1 . ..:;: T111p:' ;:=nd ·=-r.:..!nl ·]\_41·· i(·!n.:..:;:
Grant Request
Program I Project Name: "Shab e Yal da" 20 16 longe st night of the yea r
Total Program Budget: $3000 .00
Requested Amount: $600 .00 to $750 .00
Percent of Total Budget: %25
Type of Request: inkind supp ort
Th is cove rs the use of Com mu nity Hall, and 1 sta ff pe rson
One -Time Request?: Yes
. ..., -~
/ i
CityPriorityFunding: P:l.o:::,s":"! c .l.aborat:c t.his quo:''U .. on ·?
; n 1 r; .
Page 2 of 3
Impacts on Cupertino ·;· ~-L :s c \'"C: ;, t .l s a:•: cdu ':: ~. :: :i '·' nd .L c ··i •:: '' t a r ,G i. :: ·,·; .: .L .: a l. .1. c ·.-; :: h :'
Community: pu.tlic tc:.' att,c~rJ:l ar,r:J l·~<"t.n1 rno.u~ ;;;r_-.rjt:t:. l1:;;;n.i;;,niF:.c-r~.'i.c,n
At Least 75 % of Fu nding Wi ll Yes
Go Towa rd Direct Service?:
Usag e of Pr i or Year's Funds :
httn ·//f'rwm <'ll r'11n P rtin,-, l"\r rr/rrr::i n t /::i rlm in n n nim .8 .<;n x?GA Td=6 61612 01 6
Grant Application Page 3of3
Requests Made to Other -, .. ,,"; LG[Y'; ''''" ~·ould h.3\'e SV'.t''" bc.:ctL:< t:c sr,cn~;r:,r Che cost .
Agencies:
Date Request Received : Friday, June 03 , 2016
h1tn -//fnrm s4 ~11 m~r t inn nr r.r/r.r r ::i n th:i rlmin n n rnm ::is n x?GA Trl =6