draft guidance: angler recruitment, retention, reactivation (r3) … · 2018-05-15 · angler...

Angler Recruitment, Retention, Reactivation (R3) program

The Depa1tment of Natural Resources (DNR) is seeking public comment on the Program Guidance for the Angler Recruitment, Retention and Reactivation (R3) Program. This a new initiative that will provide financial assistance to partners who conduct Angler R3 programs and activities in Wisconsin. The DNR is seeking public comment before fom1ally announcing a grant oppo1tunity for this initiative.

Background. The goals of the Angler Recruitment, Retention, Reactivation (R3) program are to: 1) grow the numbers of anglers in Wisconsin and 2) expand angling pa1ticipation among adults,patticularly from non-traditional audiences. This program will help to ensure the education anddevelopment of competent, safe and ethical adult anglers.

To achieve these goals, the DNR will award cost-sharing funds through a competitive application process to local community-based organizations, community centers, government agencies, Wisconsin Tribes, colleges, tmiversities and schools.

This initiative will be administered as a reimbursement program. This means that award recipients must incur and pay costs associated with the project before seeking reimbursement from the DNR. Further, project work begun before the start date or after the end date shown in the contract between the DNR and successful respondents are ineligible for reimbursement. No advance payments will be permitted. It is possible for award recipients to request partial reimbursements from the DNR on a quaiterly basis during the life of the project. Please see the Angler R3 Program Grant Application Guidance for details.

This initiative will award federal Sport Fish Restoration (SFR) funds. These funds are derived from a federal excise tax on the sale of fishing and boating equipment, and motor boat fuel sales. Federal funds are allocated among the states and U.S. territories according to a formula based on the number of fishing license-holders in the state and the geographic land/water area of the state.

The DNR plans to announce the beginning of the first grant cycle around June 15, 2018. Applications will be due no later than September 17, 2018. Awards will be announced and contracts issued no later than mid-February 2019. Successful applicants can begin their projects as soon as they sign contracts with the DNR.

Next Steps. Once the 21-day comment period is complete, all comments will be considered and revisions will be made to the draft Angler R3 Program Grant Program Guidance as warranted. A Response Summary will be prepared and both the Response Summary and Final Program

Guidance will be made available using the existing DNR Program Guidance web page (https://dm.wi.gov/news/input/guidance.html) and will be posted on the Angler R3 Program web page.

Contact. Public comments should be sent to Theresa Stabo no later than June 6, 2018. E�mail: Theresa. [email protected]

Angler Recruitment, Retention and Reactivation (R3) Program Grant Application Guidance

Wisconsin Department of Natural Resources (DNR)

We are pleased to invite you to share your time and talents to ensure that the conservation of Wisconsin's natural resources endures long into the future. We look forward to reading your application that outlines projects that celebrate strong partnerships and will grow the community of anglers.

Table of Contents I. Program Goals and Introduction

II. General Guidance for a Successful Grant Ai1plic11tio,n A. Plan and Communicate! Contact Infmmation B. The Outdoor Recreation Adoption Model C. Eligible Project Sponsors D. Program Priorities E. Source of Program Funds F. Total Available Funding and Award Cap G. Program Grant Deadlines H Eligible Project Costs 1 Ineligible Project Costs J. Sponsor Responsibilities

1. Financial Responsibilities. 2. Official Aµthoi'tzillgResolutio11; 3. Cost Cpntai\ilile11t. .. · · 4. Local Sh~h, & Donati6ns.

K Grant Application Review } Application Scotiti.g_Crjte1ia.•--·.·._.

L. How.toAfro:iniize Yoiir Qi:antAppliccttiqn "-"~" M Awqi'd1.1ndGri111t,4,greeniel'!_I~> ...... . N. Riiilnbursement PrJde:;.s .. · ... 0. Fi11a/Report Requireniin_ts andD~/irerables

III. GrantApplication Instritdions< i> IV. PlanningR~sources

D-U-N-S N~niber Links to Best Pra8tices, Planning Tools

Page# 2

2 -11

11-14

15

V. Planning and Re;6tt,in~;orms and Samples 16 - XX • Angler R3 Grant Application, Form 8500-164 • Sample Authorizing Resolution • Grant Partner Project Data Report, Form 9300-230 • Grant Payment Request and Worksheet, Form 8700-001 • Volunteer Labor Worksheet and Summary, Form 8700-349A • Donated Professional Services Worksheet, Form 8700-350 • Angler R3 - Final Report, Form 8500-165 • Educational Outdoor Skills Activity Participant Report, Form 8500-166 • Authorized Mentors Outdoor Sldlls Activity Participant Report, Fonn 8500-167 • Sample Angler R3 Grant Agreement, Form XXXX-xxx

I I. Program Goals and Introduction

The goals of the Angler Recruitment, Retention, Reactivation (R3) program are to 1.) grow the numbers of anglers in Wisconsin and 2.) expand angling participation among adults, particularly from nontraditional audiences.

To achieve these goals, the Department of Natural Resources (DNR) will award cost-sharing funds to local community-based organizations, community centers, government agencies, Wisconsin Tribes, colleges, universities and schools to ensure the education and development of safe and ethical adult anglers.

Human dimensions research has long identified food, natnre. appj!ciation and time with family and friends as key motivating factors for fishing. For these and 111tui}'otJ;ier motivations, pilot studies in Wisconsin and elsewhere have shown that there is strong interest in.fishing from adults and family members who have never fished. In response to nation.aFresearnh findings about perceived barriers to fishing, education and training for new anglers all.d lll~J'ltors is needed. ·

The DNR understands that it is necessary to work with partners t<J J:ind solutfonsthat will ensure futnre generations of anglers have the knowledge, skills and abiJities to become inforrneg; competent, safe and ethical anglers. By developing a private0 p1.1blic paiinershipi-ehnbursement program, the DNR is acting on the idea that only long-term mentorshiP.orinstruction by a Committed angler with good teaching and communication skills can properly educate,<traiii and develop a new angler.

The new Angler R3 Program is an evolutio~~fthe DNk'.$Angler Education program, which has successfully provided for thfihtegrati?n of fishi11g in school curricula, at community and recreation centers and through after0school prOgl.'<J.lllming entities that have allowed for repeated fishing experiences for youth ancl often, theirfamilies. Thepritical difference between this new prograin and past efforts is the requirementJor an evaluation component: data collected about participants will enable the D~Rto.track and evaluate the fo11gcterm license-buying habits of paiiicipants. It will focus on education, trfilning an.ddeveloptnent of Wisconsin's anglers, paiiicularly adult women and fainilies, and especial/f people from 8ommunities of color. Recruitment of new anglers, retention of active anglers and foactivation oflapsed anglers ( collectively known as Angler R3) are impmiant to future conservation funding and progranirelevancy

II. General Guidance for a Successful Grant Application

A. Plan and Communicate!.

1- Follow these instructions and those on the application (Fonn 8500-164), carefully. Start planning your project eai·ly and communicate with the DNR Angler Recruitment, Retention and Reactivation (R3) Coordinator often about your project goals. Contact information appears on the next page. The most qualified applications will implement best practices that have been established by practitioners in the field of outdoor skills-based outreach and education. A list of resources to guide your planning effmis for your project are found on page 15.

DNR Angler Recruitment, Retention and Reactivation (R3) Prograin 2018 2

2- The DNR encourages novel, outside-the-box projects with good strategies and measures of effectiveness. At the same time, projects don't have to reinvent the wheel - if there's something that has been documented to work, build on it and evaluate your successes. The DNR anticipates that projects will be solicited every two years, starting with 2018. The frequency may change if funding availability changes. Periodically check the web page for this program regarding application cycles.

3- As costs are incuned, save all proofs of purchases (examples: invoices, receipts, etc.) and proofs of payments ( examples: cancelled checks, credit card statements, etc.). Make sure to document volunteer hours with sign-up sheets as the hours are worked; those documents must include volunteer signatures. The DNR has sample volunteer time sheets that we recommend yot1 \Jse. Establishing a system for these actions from the beginning of your project eliminates frantically searching for documents and trying to remember number of hours worked and who workeqj#efu, when reimbursement requests need to be submitted. · · ·

· .. , ·::-.-.

4- Finish your project before the expiration date, y1I-ticih~ill appearonpigeJ of your grant agreement. If you need an extension on your agreement, contacfthe Angler R3 Coordiiiator before the grant agreement expiration date to request the extension. 1'-1\it.e that costs incuned by you before the start date and/or after the end date of your agreement are not eligible for rellllbursement by the DNR.

5- The DNR and staff of the U.S. Fish aniL\Vild)ife Servi:ecir\,eir agents have the right to audit or examine all books, papers, accounts, docui11~nts6r other records related to project costs that the DNR will reimburse. The purpose <Jfthe audit is to .vi;rify tha(clajmed proJect costs are eligible and comply with the terms of your gra,nt agreement, and wert) •. actuaUfi11curred. Grant recipients agree to retain all project records until finaltesolutioI19(a,ny audi1:findit1~s, or fcita,p~riod of three years following the date on which the DNR iss)led final reill'lbursement, :whichever is la.for.

6- MOST IMPPET4.N'fL Y, askqµ~stio11s ofthe Ali~i~r R3 Coordinator if you don't !mow how to proceed orne~d.clatificatiqn on topics such aseligible 2dsts or project administration procedures.

,._._ .··-· .. -, ,',, ' ,'. •·, ', ',"'

Contact Information

Theresa Stabo, Angler R3 Cooh:linator Department ofNatur!lLResourc~s Bureau of Law Enfortem:~n,t,l,E/8 P.O. Box 7921 Madison, WI 53707-7921 Phone: (608) 577-6332 Fax number: Available upon request. E-mail: [email protected]

Jill Sunderland, Angler R3 Grant Manager Department of Natural Resources Bureau of Community Financial Assistance 810 W. Maple Street Spooner, WI 54801 Phone: XXXXXXXXXX Fax number: Available upon request. E-mail: [email protected]

DNR Angler Recruitment, Retention and Reactivation (R3) Program 2018 3

B. The Outdoor Recreation Adoption Model The Outdoor Recreation Adoption Model (ORAM) is based on approximately 30 years of hunting, shooting, and leisure science research, and is summarized in the diagram below. The model is applicable to shooting, trapping, and angling.

,---- Reaqtiv,c!tlon ----, 1 LAPSE I I REACTIVATE I

: t-11-l : I l I I I __________ l I _________ I

,-----------, R_!3cruitme,nt ,-----------, 1 AWARNESS 1 1 INTEREST 1 1 TRIAL 1

,------ RE/tertion ________ , : :-..: :-.: : t I l 1 I I I_________! 1 __________ I I ___________ I

DECISION TO : CONTINUArJoN: : CONTINUATION : CONTUNUE -- : W/ SUPPORT :-""j W/OUT SUPPORT : 14 ___ _J

I __________ J f ______________ !

Outtloor Recreatio11 Atloptio11 Mot/el

Repeated training

The process towards becoming an activepiu:ticipant can b~mapp;d and tracked. The ease with which an individual makes progress to the ultimategoalofcontinuati<m depends on the individual's cmrnnt age, age at initiation, gender, ethnicity, riskaversion and many other. factors. Many cmTent R3 efforts exist on the far-left side of the model. This niodel identifiesthe process of moving people from interest to continuation ( an outcome) as its primary goaL · ·

High quality applicati6iiswill re~ogn~e and utiliiefhe ORAMimd identify the pathway that potential anglers or reactivated anglers will take as a result of the proposed project.

C. Eligible Project Sponsors D Wisconsin &mnties; towns, villages, and cities D Wisconsin Universities; Colleges and Technical Schools D Other Wisconsin governmental units; as.defined ins. 66.299, Wis. Stats. D Wisconsin Tribes · · D Wisconsin School Districts D Cmrummity-based Organizations (i.e., nature centers, social service agencies, public health centers -

particularly those thats,erve coIIll1iunities of color) D Food security and Ioca1 foods6rganizations D Most, if not all, conservatiqJ1.6tganizations (i. e., local rod and gun clubs, sporting organizations,

local chapters, and national organizations)

D. Program Priorities Top priority-

• Projects that clearly identify best practices and implement systems with documented success at producing new adult anglers who would not otherwise become anglers. An example of a successful effort is the Fishing for Dinner program, that has had measurable outcomes in effective angler recruitment.


• Projects that implement approaches that have been demonstrated as effective at meeting Wisconsin's Angler R3 goals as stated on page 2, and that train potential anglers in specific actions or programs.

Second priority -• Projects that test or trial new angler reactivation programs. • Projects that implement known effective angler reactivation programs.

Third priority -• Projects using systems that educate and train new adult anglers. • Projects that effectively re-train mentors or instrnctors wl,cfWjll commit to new anglers for a

period of years through multiple introductions and edt1ca#9nal experiences in fishing.

Fourth priority- < .. i \ ... • Projects that mirror the DNR's original AnglerE9ucation progrnm, and/or improve upon that

progran1 by collecting data on participants t9 .enable the DNR t6Jt1.1ck participants' future license-buying habits, and on family or loµg,term community involv~Jllent.

Other priorities - May be determined by the DNR Secretary anclt)le Sp01ii11i.Heritage Council. Such priorities will be listed on the Angler R3 web page at the begillllirig; of the grant cyqle,,

E. Source of Program Funds ).. •. < / • .. ·.··

This program will award federal Sp01i Fiih;Js.estofation funds>These funds are derived from a federal excise tax on the sale of fishing and boating equiplllent, @d motorJ?oat fuel sales. Funds are allocated among the states and U.S. ten-it9ries based o!\ ~formufa th<1t it1cludes the number of fishing licenseholders in the state and tile, geographi9)and/watei" are<;1()fJhe Stll.tt:.

F. Total Available Funding and Awafd Cap ... The DNR will award a totalof$75,000 during the fi:tstcycle. The maximum award amount for one project will be $19,000,.'fhe D1'-[R,l;l11.ti6ipafo~JclJ11inistering this program and accepting grant applications 011ly in ev~ri numbered Years. . .

If the value of the projectsol!hjned inflle grant applichtion exceeds available funding, applications will be scored based qµ program criforja, ranked)Jy score, and evaluated for funding by a group of angling specialists (inchic:ling external partners) wh6\vill make funding recommendations to the DNR Secretary's Office.Award decisionstifthe DNR Secretary's Office are final.

G. Program Grant Dt!adlines* •• /

Activity ~tt· Proposed Deadlines

DNR makes arant annlicatiorln1aterials available on-line June 15, 2018 Deadline for oroiect soonsor to submit aoolication to DNR* Seot15, 2018 DNR notifies oroiect soonsors of application status followina review Dec 1, 2018 DNR issues qrant aareement Feb, 2019 Project start date Feb, 2019 Project end date Dec 31, 2021 Deadline for reimbursement reauests to be submitted Mar 31, 2022

*NOTE: Pers. 990. 001(4)(c), Wis. Stats., if any application deadline falls on a Saturday, Sunday, or State Holiday, the deadline is moved to the next State working day.


H. Eligible Proiect Costs • Salaries, hourly wages and fringe benefits for applicant employees • Consultant Services • Purchased Services - examples: printing, mailing, room rental • Other purchased services (specify in grant application) • Office or project supplies (specify in grant application) • Project's programming supplies, such as fishing gear (specify in grant application) • Background checks of mentors and instrnctors (required) • Equipment purchase ( defined as items that cost $5000.00 or more) • Hourly equipment rental charges ( specify in grant applicatfoh) • Other (specify in grant application), e.g. bus or van rentaLfo transport classes for fishing outings

NOTE: This is where you list costs that are needed to implement the project but are not captured in the items above. · · · ·

I. Ineligible Proiect Costs • Costs incuned before the start date or afterthe end date of the granfagreement from the DNR. • Costs of routine fishing site maintenance incltiding, but not limited to, triowing grass, painting

signs and debris removal. • Costs for which payments have been or will be received under another fedefal funding source. • Fines and penalties due to violationofor failure to comply with federal, state or local laws and

regulations. · •..•••. · · .

• Applicant's ordinary operating expenses, such as salaries mid expenses of public officials that are not directly rele1tedto the project. ·· .. ••· .·. ••-··. ·

• Boats, auto, trncks or office furniture purchases. • Capital improvement projects: • Fee simple or easem:entland acquisitions.

J. Sponsor Responsibilities I. FinandalR.esponsibilities,The financial responsibility contained in a grant agreement cannot be transferred to another entity by e1resolution or any other means. All reimbursement requests must be submitted by the sponsor named oil the grant agreement.

Cautions: • If a consultmit completesthe grant application for you, be sure to check the completeness

and accuracy of the information provided. Remember, as the applicant, you are responsible for the accuracy 6f the information provided in your application and fulfilling necessary requirements.

• Expenses incurred by a volunteer(s) completing tasks during the project period can be considered an eligible project expense. Compensating a volunteer beyond incurred project expenses may mean that the volunteer( s) should be considered an employee or independent contractor. For further information, please consult your attorney.


2. Official Authorizing Resolution. Every application submitted must include a resolution adopted by the applicant's governing body. This resolution must do the following:

D Authorize one representative, preferably by "title" rather than by name, to act on behalf of the applicant's organization to:

• submit an application • sign a grant agreement with the DNR on behalf of the applicant • talce necessary action to complete the project • request reimbursement from DNR • submit a final report to the DNR

D Resolve that the applicant has funding from sources other thaiiJhe DNR for the local share D Identify another cooperating eligible sponsor ( only when Sp!iCJol Districts are involved)

3. Cost Containment. Applicants must follow procurement{~quirements contained in Wisconsin Statutes. This means that for purchase of goods or se1'\liC!')S ( ex. contracted work) costing between $5000 and $50,000, applicants must obtain and docu11-1e11t three written pr\ce quotes. See link on the Angler R3 web page for procurement guidance forjofal governments. ·

4. Local Share & Donations. "Local share," also k11ow11 as "matcl:i." refers totliatportion of the cost of the project ( 50% in most cases) that is I)Ot 9oming from. Pl'{J.Z ful}oS or from other fedyral sources.

Local share may consist of: .. · . • . • Cash raised by the applicant i i · .·.· ................ •··. · ·. • Funds from a party other than the DNRor a foderalagency • Value of volunteertiirie:. · .·. · ··· ·. · · ··

• •

Value of donatedlab()r, serVi~!')S. or mate1·i;µ~ / · Value of some equjpll).ent useclii't the proj~ct

Donations are subject to thefollo'Ningtl()visions:

• AU soµrce:{6J'i11e local shaie aiid dom1tion.s muktbe indicated in the application • Th~ lllaximum hourly value assigned to donated labor is usually the state minimum wage • The v~lLJe of donated eqtiipmentuse or the value of donated materials shall be detennined by

market rate.and be establisl)ed by in.voice from the donor. Contact the Angler R3 Grant Manager fcfr additional guidai\ce. ·

• The value of professional s~rvices is determined by the donor in a letter on business letterhead.

K. Application Review ·>·. / . .i Applications will be reviewed by a team consisting of internal and external specialists with experience in angler and mentor training a.11drecruitrnent and selected by the DNR Office of the Secretary. The Sporting Heritage Council will have a role in the application review. Each application will be scored based on program priorities and on the detail included in the application. See Table 1 A for Application Scoring Criteria. Applications will be ranked in descending order, based on the application score. Eligible, clearly-written applications will be funded, based on project rank, until available funds are exhausted. The Office of the DNR Secretary will approve awards; decisions of the DNR Secretary are final.

Only complete applications will be ranked and considered for funding. A complete application includes the following characteristics or items:


• A signed, complete application submitted before the posted application deadline.

• All nine sections of the application form are completed with enough detail for the reviewer to understand the project.

• A complete project budget.

• An authorizing resolution approved by the applicant's governing body.

Table IA. Annlication Scorinf! Criteria

Topic- Maximum Possible Score= 255 Points

Project Approach, Design and Scope 60 points maximum

• Scope of work is aligned with goals of Angler R3 Program goals identified 91{page 2 of this document.

15 points

• Project is research based, utilizing best practices established by practition~rs in the field of outdoors 15 points skills-based outreach and education. (See page 14 for resources.)

• Application is characterized by a strong public-private partnership, Nariie partner(s) and describe 15 points their ro/e(s) in your application.

• Proiect clearlv identifies target audience, orogram goals, learnfo!i obiectives, and eval,iation tools. 15 points Intended Audience(s) for Project Part A- Angler Recruitment and Training 60 points maximum

• Project uses innovative approaches to recrnit andretain new at/11ltanglers and/or family groups • . ·· ... 20 points • Project implements a system that is known to effecHvely reactivate lapsed anglers .

• Project implements a system that is known to effectivel:r recruit youth anglers and includes a system 20 points to track them to license-buying age. Additional Weight\vill be given to programs within the project

20 points that target hlgh school students of license-buving ae:e; ·. . :,;.:,

Intended Audience(s) for Project Part B - Mentor Recruitment and Training 40 points maximum Either #1 or #2 will be scored denendinP on intended audience of project.

# I. For an adult- or family,oriented program. Projectproposes to re-train instructors to become long-tenn mentors who will commit to a new adult angler or family of anglers for multiple trips over multiple years. Examples:

• 0 points if mentors .are trained to participate ih single event or does not include mentor tn;mirtg. · · · · · · · ·

• Up fo 15 points if mentors are train_ed to provide multiple trips and instruction to new adult anglers ()r family of angle!'~. . 40 points maximum

• Up to 20 points if mentors are.trained foWork with non-traditional audiences in their recruitment efforts. (Adult fe111ales and under,represented audiences, especially people from comniuriiti~s or color and,ife~ immigrants.)

• An additional 5 points are awarded if mentors are trained to mentor until the new angler is

OR fully integrated into.the fishing connnunity. #2. For a youth-oriented program . . Project proposes to train instructors or mentors to connnit to providing multiple trips for a new class, group or family of anglers for over the course of a school year or program. Exatilples:

• 0 points if mentors/instructors are trained to participate in single event or does not include mentor training.

• Up to 15 points if instructors are trained to provide multiple trips to a class, group or family of anglers. Additional weight will be given to instructors trained to work with high school 40 points maximum students of license-buying age.

• Up to 20 points if mentors are trained to work with non-traditional audiences in their recruitment efforts. (Youth and their families from communities or color and new immigrants.)

• An additional 5 points are awarded if instructors are trained to provide instruction or mentorshin until the new anglers are fullv integrated into the fishing comrnunitv.


Likelihood of Pro·ect Success and Lon -term Sustainabilit • Project includes plans to ensure the long-term sustainability and the ability of the

organization to effectively carry out the recruitment, retention and/or reactivation activities beyond the grant period.

• Project builds capacity for the applicant's existing program that has been proven to recruit and retain adult anglers. OR Project implements a new program within the applicant's organization that has been proven successful elsewhere by others, to recruit and retain adult anglers.

• Measurements of success are adequately documented in the project's approach, evaluation and results sections.

• Scope of project reflects a realistic budget and amount offunding requested and matched. • Project is adequately supported by allocation of staff time and supplies necessary to complete

the work. Describe fitlly in application. ·

A well-organized reporting system and evaluation process are essential to eniible µs to track the longteim outcomes of these programs. These processes should include a meanstbcori:d\lct longitudinal studies ofpm1icipants to determine if these programs have been successfuiin developjng anglers who routine I urchase annual fishin licenses. .·. ·.· · · ·. ·

Bud et Collaboration Pm1ion of total project costs contributed through match, by apjilica:nt.

TOTAL MAXIMUM SCORE Note #1: This number is less than total points listed iiec~use it is not p<lisible to earn the total number of points listed for each topic category. · ::" \ ·. / > : ( Note #2: It is unlikely that any applicant will earn tb~ total numl:>er_of points in each topic category. · · · · · · · · ·

L. How to Maximize YourApplicatidh Score

55 ointS maximum

20

15 points

10 points

10 points

10 points

20 oints maximum ~ 25% ~ 0 points

26% - 50% ~ 5 points 51% - 75% ~ 10 points

>76% ~ 20 oints

255 points

High quality apIJl~c;iti()~s wiil l-ec()~nize add utilize th.e Outdoor Recreation Adoption Model (see page 4) and identify the pathways. tilat potenti11J a,11glers or reactivated anglers will take, as a result of th~ir participation in the ptoposed project's programming activities.

> .. ·>: ',,,'_:>,-, -:,:_:,:·.·,'.

Applicants should focus on implefuenting ;rograms that have been documented to be effective or that are in the pilot oHrialstage and appear promising.

Each application must inqlµde a d~tailed and complete description of the approach, objectives, and specific measurable outcomes, Applications referencing known best practices and detailing a system for long-tetm evaluation of effectiv:eness at educating, training and developing new adult anglers will score well and be highly ranked. Public/private partnerships and multiple funding sources will enhance the application's score.

Quality applications will include a mechanism for the applicant to collect the DNR customer identification number from all project participants. All grant recipients, including school-based program providers, must submit this data with final project report. The DNR will use data submitted for future program evaluation. It is strongly recommended that project partners use the DNR' s participant roster, Fotm 8500-166, for this data collection effort. If you use another method to collect these numbers, describe it in your application.


Be elem· about how you quantify outcomes of your project and how the project will have positive measurable effects on growing the angling community. Estimate how many programs you will rnn, how many sessions each program will have, and how many participants will be served by each program.

The Angler R3 Progrillll often involves interactions with small groups or one-on-one instruction and mentorship of individuals, often minors or others from potentially vulnerable populations. To protect all participants from abuse, safegum·d the reputations of mentors and instructors and maintain program integrity, grant recipients are required to conduct background checks on all participating mentors and instructors. The cost to conduct background checks is eligible for reimbursement under the Angler R3 Progrillll. Some instructors may already be DNR-certified instructors or mentors so will already have had a background check on file. To detennine this, please contact the Angler R3 Coordinator at the DNR. . ...

M. Award and Grant Agreements Upon selection of your project, you will receive a notice of award and grant agreement from the DNR detailing the approved project scope, project time of performance, and appr6ved budget. Read your grant agreement carefully and share it with your c11nsultant (if you are wori<ing with one). Your grant agreement will contain conditio~sthat govern your project. Make sure ytmr consultant agrees with the project scope and conditions described in the grant agreement before you sign it.

Successful applicants must sign both copie{9fthe grant agreen1eiit and return one to the Angler R3 Grant Manager within 30 days of receipt frorn the DNR. (See page 3 for grant manager's mailing address.)

N. Reimbursement Process

Important! . . . . Costs i.nciirred prior to the start date or after the .end date listed on the grant agreemenfare nofeHgible fot reimbursement by the DNR.

This grant program is administered as a reimbursement program. This means you must incur and pay all costs associated with the project before seeking reimbursement from DNR.

It is possible for grant recipients toj"equest partial (quarterly) reimbursements of the DNR during the life of the project. The quarterly reimbursement would cover the following timeframe:

• January 1- March 31 • April 1- June 30 • July 1- September 30 • October I-December 31

Grant recipients must use DNR Form 8700-001 to request reimbursement. Grant recipients inust also submit completed DNR Form 9300-230, Grant Partner Financial Data Report. Since funds provided under this grant program are from a federal source, grant recipients are required to submit Fonn 9300-230 with each reimbursement request.

DNR Angler Recrnitment, Retention and Reactivation (R3) Program 2018 10

Submit your reimbursement request(s) to the Angler R3 Grant Manager (address on page 3 of this document). Attach the following to the completed, reimbursement request (Form 8700-001): proofs of purchases ( examples: contracts, work orders, invoices, etc.) and proofs of payments ( examples: cancelled checks, bank statements, credit card receipt, credit card statements, receipts marked "paid in full" with date).

The total of all partial reimbursements shall not exceed 90% of the total award amount. The last 10% of the project budget will be maintained by the DNR for the final reimbursement payment; a final report must accompany the final reimbursement request from the grant recipient and final submission of Grant Paiiner Project Data Repo1i, Form 9300-230. Final reimbursementrequest will not be paid until final repmi is reviewed and approved by DNR. · · ·. · · ·

0. Final Report Requirements and Deliverables / f ? A final repoti that describes the project's results as well as ¥:v requir(:d project deliverables, must be prepared and submitted to the Angler R3 Grant Man~g¢iwithin 60 d~y~pfthe end date of the grant agreement or completion of the project, whicheverpdctirs first. The DNR1Uay require periodic progress reports for multi-year projects; this will be stated iii the grant agreement. · ·

Results and summaries of funded projects will be shai'ed,jnclu<iingmaterials produced, photos, project research results and data collected for pl'ojeft assessments,tptheextent allowed by Wisconsin's Open Records Law. · · · ·

Credit shall be given to both the grant rec if i;ht~rid Jb,() DNR ih ajiy material published or released to the news media as a result of this project. · ··· · ··· ··· · · · ··

I III. Grant ApplicatiQ.;: tn'.stfu~tions .

On the application form i;.>lll attachecl stlpporting clojl!~ents, yo~ :ust completely and in detail address all the following sectfon,s and(eq)lir\)ments.

Section I:< / Applk<llltf1i{a.ppli~anf111tiybc: acounty, city, village, town, local ApplicaiJJ .... ·· govetrilp.(:11tal unit;pniversity; ci:>llege, technical school, tribal unit of Information•· govermiiertt, qualiffo~ 11on-governmental organization, qualified

conservation p;-ganizatipn ( defined as a non-profit, tax exempt organization >that meets cert:rin additional IRS requirements), non-profit social services · organization, food security systems organization or school. Name the

applic<lllt and ch~ck the box that describes the applicant. By submitting this applicati911,)'0J1 ai·e agreeing to a background check of instrnctors and mentors<invo.lved in your project, (see page 10).

You will also need to obtain a Data Universal Numbering System number, (D-U-N-S numbe1). This unique global business identification number is free for businesses required to register with the US Federal Government for contracts or grants. Please click this link D-U-N-S Number Assignment or use your browser to locate the website.

Authorized Representative Named by Resolution: The authorized representative must be the person named and authorized by a resolution of the applicant's governing body, to act on behalf of the applicant by submitting the application and all related documents, request


Section II: Project Need

Section III: Project Purpose

Section IV: Project Objectives

Section V: Project Approach

reimbursements, receive payments on behalf of the applicant, and take necessary action to complete the proposed project. A consultant hired by the applicant may not be named as authorized representative for the project.

Project Contact Name: The contact person is the person the applicant designates to perfonn day-to-day management and coordination of the project. The contact person may or may not be the same person as the authorized representative. The applicant may choose to designate a consultant as the contact person.

Justify the need for this project. Which Angler ,R3 need are you addressing? Demonstrate/document the demand for this p\oject. Why is this project necessary? What will happen if this projectis not funded?

Which "R" do you intend to addres~? \\/hat sfages on the Outdoor Recreation Adoption Model will you be add1;dslng and/or cbnnecting? Demonstrate or explain the pathway your projectProvides.

Based on the need and purpose for this project, outline your objectives in specific detail. What outcomes willyou a9hieye? Describe in detail how your project will meet those objectives. Include<111easurements and outcomes that will define whether the objectives were 1net.

Provide a detailed descrip1:ibri o[Jhe apprnach for your project. Include a timeline .and benchmarks. Whafwill be done arid when? Describe specific actions arid )'"OUl' target audience(~).Iclentify Htefature and examples of suc:cessto guide your project. Identify detailed methods that will result in meeting stated objectives. Attempt to address potential questions before they arise. Such as:

. • Desci'ibe irt detail ho.W you will. measure/evaluate project outcomes. • Is .your project focused 011 developing new adult anglers from a broad

demographic? • HoWwill you welcome new female anglers? • How Will you welcome potential anglers from communities of color? • Has your approach been shown to be successful elsewhere? If so, how? • Does this approach involve a single experience as an introduction or

wiH it require a longer-term contact with participants? • Does th.is approach test innovative ways to develop, train, and educate

anglers'? • How will you demonstrate and report on the progress of your project?

This is the heart of your application and should provide the reviewers with a narrative that gives a full picture of your project. Write your project description commensurate with its size and complexity. For a relatively simple small-scale planning project, a few paragraphs may suffice; for largescale planning or longer-term project, you will need to provide more details.


Section VI: Project Timeline

Section VII: Results and Benefits Expected

Section VIII: Cost Estimate and Funding Request

Identify important dates for your project, including any benchmarks to ensure work is progressing on schedule. Examples include project start date (work may not begin before Jan/Feb 2019) and project end date (no later than December 31, 2021) as well as impmiant estimates of when key components of the project are anticipated to occur.

How will this project address the need identified earlier? What effect will this project have on angler numbers in the future and why? How will that effect be measured? Will this project result in new anglers who would not otherwise have had the opportunity to fish? How will that effect be measured? Will the project measure and eval!Utte the effects of other angler training and development effmis? How willthe benefits of this project be expanded to other areas of the state orpthefprograms?

The cost estimate is divided into fyro. colurnnsi' orJach cost category: Cash Costs and Donated Value. /

Column A C.llsh Costs: those c;qstsJh~ applicant expects to incur specifically for the proj ed and will pay in cash, either outcofC: ocket or with 1\W(lrded funds.

Column B Donah;dVallie;Jhe value of(ionated labor, services (Ind goods that coritributedirectlyJ()the progress of the project and the V(llueofwhich\:vill be documented by invoice 6rothetreliabfe means.

Enter your projected costs for eacli applicable cost category 1 through 11 1ist"d in SectiqriYII, ihdic(lting for each category the portion of the cost that

. is a (;(l~h Cosfa11d the portion, that is Donated Value. Most projects won't have c:oitsjn all categories. R.eferto the instructions below for descriptive notes for cetiain costc(ltegories that may not be self-explanatory or which have specifie,J·equirements.

Salaries, wages and employee benefits: Column A - Cash Costs, includes salaries, wages and employee benefits paid by the applicant to his or her own employees for work directly allocable to the project and documented bytime sh~ets and payroll records. Column B - Donated Value, includes the vahie c,f labor donated to the project. The value of such labor is limited to a maximum value of the market rate for similar work.

2. Consulting services: Column A - Cash Costs, include the full cost of the consulting contract(s) for the project. Column B - Donated Value, includes the value of donated professional consulting services valued at the rate the professional person identifies for similar work performed for pay.

3. Purchased services--printing and mailing (specify): 4. Other purchased services (specify): 5. Supplies (specify): Supplies are consumable items with price ofless than

$5000.00 per item, e.g. fishing gear.


Section IX: Certification

6. Hourly equipment-use charges. Include any rental costs in Column A and the value of donated use of equipment in Column B. Donated rates may be either a) the actual rate charged by the donating entity if the donated labor is within the scope of their usual professional work orb) a per-hour donated rate in line with the donated equipment use rates referenced above.

7. Other: List costs that are needed to implement the project but are not captured in the items above, and enter the sum of these costs, ( examples: boat or facility rental; specify).

8. Subtotals: Add up the numbers in Column A - Cash Costs, and enter the sum in Column A on Line 9. Add the numl:Jers in Column B - Donated Value, and enter the sum in Column llortLine 9.

9. Total project cost estimate: Add toget!:t~rthe numbers from Columns A and B from Line 9. Enter the sum in the box for Line 10. This is your total project cost estimate, incluping costs the applicant will pay with cash and the value of donateqJabor, services arid goods.

10. State share requested: The state share requested is up to 75% (to a maximum of $10,000) of the total project cost estimate from Line 10, and not exceeding the total cash Costs from Line 9, Column A. Use the worksheet 011 the application totally the state share requested.

Be sure that the representative authorized by resolution of the applicant's governing body signs aml dates the application! Applications must be subi:riitted or postniarked no later than the deadline shqwllon page 5. .

Submit completed applications to: Jill Sunderland, Ariglet R3 Grant Manager Department of.Natural Resources 810 W, Miiple Street Spoone1', WI 54801


IV. Planning Resources

• D-U-N-S Number Assignment This unique global business identification number is free for businesses required to register with the US Federal Government for contracts or grants.

• Locavore Guide - Nourishing Interest in Hunting and Angling. • Hunting, Fishing, Sport Shooting, and Archery Recrnitment, Retention, and Reactivation: A

Practitioner's Guide.

Additionally, the following list of resources was compiled by the Recreational Boating & Fishing Foundation (RBFF) to help you throughout your Angler R3 plar1nibg process.

• Best Practices Workbook for Boating, Fishing and Agtiati~ Resources Stewardship Education o Best Practices Guide to Program Evaluation. ·

• Recommendations and Strategic Tools for Effe~ti~e Angler R~brnitment, Retention and Reactivation (R3) Efforts · · · .·

o List of Angler R3 Threats . o Outdoor Recreation Adqptie>n Model (OR,\NI)

• Highlights of Angler Recrnitment, Retention and Reactivation (R3) Literature

• Toolkits: o Direct Mail& Email!Vfarketing;Toolldt to R.e~ctivateiapsed Anglers 0 First-TimeBuyersRetention EmaiLCarripaigh toolldt . o RBFF 60 in_ 60 Digital Toolldt - Inch.id.es state 60 in 60 license sales goals

• RBFF Research o Hispanic Market Research o · RBFFEvaluations

•· o . Boating & Fishing Reseal'ch

• Demographic Links: . ·.·•·•·.·• o Ari1erican FactFindeh US Cen.sus Bureau - Find popular facts and frequently requested

data ab<mt your coffil!lunity o Pew Research Center-; Hispanic trend


V. Planning and Reporting Forms Samnle Grant A!!reement

You will need the following forms to plan and report on your Angler R3 project (sample forms, as well as a sample authorizing resolution and a sample grant agreement, are found on the pages that follow):

• 8500-164-Angler R3 Grant Application, (4 pages) • Sample Authorizing Resolution, (I pages) • 9300-230 - Grant Partner Project Data Report, (4 pages) .. • 8700-001 - Grant Payment Request and Worksheet, (4 p:lges) • 8700-349A - Volunteer Labor Worksheet and Summary, (4 pages) • 8700-350 - Donated Professional Services Worksheet, (2.pages) • 8500-165 -Angler R3 Project Final Report, (2pages) • 8500-166 - Educational Outdoor Skills Activity Pmticipant Repo1i, (2 pages) • 8500-167 - Authorized Mentors for Educational Outdoor Skills Activity, (2 pages) • Sample Angler R3 Grant Agreement, (X pages)


State of Wisconsin Department of Natural Resources dnr.wi.qov

Angler Recruitment, Retention and Reactivation (R3) Project Proposal Form 8700-372 (2/18) Page 1 of4

Notice: Complete and submit this form to request Angler R3 Program funds from the Department of Natural Resources (DNR). Incomplete forms may not be considered. Personal information collected on this form will be used for program administration and may be provided to requesters to the extent required by Wisconsin's Open Records Law (ss.19.31-19.39, Wis. Stats.).

Instructions: Download and follow the instructions starting on page 11 of the Angler R3 Program RFP Guidance. Fill out form completely and submit electronically along with any supporting documentation (if applicable). All applications must be complete upon submission. Applications will be scored as they are received. Applicants will not be contacted for additional information. For application questions, please contact [email protected]. Additional information and scoring criteria may be found at: http://dnr.wi.gov/aid/grants.html.

_,,;,::;:;:;:x. Proposals that implement systems with documented success at producing new a\l.~.l!:i;iijglers who would not otherwise become anglers will receive top priority. Next priority will be proposals that test or trial new idea~,,~ij~}ystems to train, develop and educate new adult anglers and those that effectively train mentors to commit to new anglers for.ifi~rjqi;J:.qf years through multiple introductions and educational experiences in angling. Other priorities may be determined byJl1fSe6rei~fy,~nd the Sporting Heritage Council.

<,'/, .. // -,,,./.,

I. Applicant Information Applicant/Organization Name

Applicant Type: O State

0 County

0 Municipality

0 Individual

Authorized Representative Name

Mailing Address

Project Title

. -'

0 University, College or Ted,f)i~'ll School O Tribal Gdt~tnmental Unit

0 Conservation Organization or/iJ~ociation 00 WI School ~ifoi6t

0 Food Securityf~q~I Foods Orgarilziiiiqh / b Other (specify) · .. ,.·•·

0 Community-~J@dqfa~~jzation ·· · ··.

· Email Address '~-'<·'·'

City State ZIP Code

Proposed Project Start Date Proposed Project End Date

Email Address

Explain why this project iif:necessary. DemiihWate the &;:/#and or need for this project. '· .. -,:_ --,-.-,.·.-, . ·.,,:,·

Ill. Purpose

Primary focus of your program project? 0 Recruitment 0 Retention 0 Reactivation

Specify if the focus of your program project is to develop new adult anglers, particularly female or people from communities of color.

Purpose/Project Statement:

---- --.1, save.).'

Angler Recruitment, Retention and Reactivation (R3) Project Proposal Form 8700-372 (2/18) Page 2 of 4

IV. Objectives Based on the need for this project, outline your objectives in specific detail. Describe how your project will meet those objectives. Identify best practices and include measurements and outcomes that will determine whether the objectives were met.

V. Approach Provide a detailed description of the approach for your project. Identify !_it<'>[atlire and ex~jijpl_es of success that led to your project design. Identify detailed methods that will result in meeting stated obji,¢ti\ies. Address th,Hq!lowing questions: • Has your approach been s.hown to be successful elsewhere? lfJ~/~iiere and how? · "<·\:, • Does this approach involve a single experience introduction ~liffiong-term contact called /q(?c_ Note: Use DNR Form 8700-001 when making reimbursement requ,a,~ts, See instructions on that fcifi\,_;_.

VI. Project Timeline

Outline your project tin:JElli9e ~i\h expected iiir~~t ef~iiisfcitrn,eeting li'riMtJmarks.

VII. Results and Benefits Expected Describe what e_ffect thi_s projecl'Wil_l:N•ve on aJ?(/fAt numbers over the long term. Explain why and describe how that effect will be measured. See 1nstruct1ons ,n the Angle_r R3 Prggrann RFP Guidance. Be complete.

, .. ,:,:-.' ,·, :-::•,,,· .

$ave... ii Subm_il by EnnaiU

<·

Angler Recruitment, Retention and Reactivation (R3) Project Proposal Form 8700-372 (2/18) Page 4 of 4

VIII. Cost Estimate and Funding Request- SEE INSTRUCTIONS Enter your projected costs for each applicable cost category below, indicating for each category the portion of the cost that is a Cash Cost and the portion that is Donated Value. Most projects won't have costs in all categories. Refer to instructions on the grant program web page for descriptive notes for certain cost categories that may not be self-explanatory or which have special requirements. Important: Costs incurred prior to the start date and after the end date of the agreement are not eligible for reimbursement.

A B Cost Category Cash Costs Donated Value

1. Salaries, wages and employee benefits $ $

2. Consulting services $ $

3. Purchased services-printing and mailing $ $

4. Other purchased services-specify: $ $

5. Supplies-specify: > $ $

6. Depreciation on equipment ./)Y•·•····· $ $

7. Hourly equipment use charges / .. · > $ $

8. Other costs, for example boat or facility rental - specify: > < f\ $

.... ~ $····)> $

\ $ > $

9. Subtotals ~dd row I .· > /.} $ > $

10. Total project cost estimate -Vf);d___ $ ··<> 75% of the total project cfost e~/imate •· ??. 11. Stateshare requested (to a maximum of $10,000) hotto exceed < $ total cash costs from Lirj~ _9, C6ltJ/Tl,/i/\

<". •••••• ········ Will you accept partial funding? OYes. Q No

IX. Certification I hereby certify that all information provided in this "llPlication arid atfap[)ments are tr~e, accurate, and complete. I understand that any information found to be inaccurate, misleading, or f'!lsified may result in disqualification from consideration for a funding under this program.

NOTE: Ple?se type your~~nw on tfie\ign(lture line.The email message generated from electronic . suprr1itt~I of this form )'iill be 0,;ed ~s ~n electr6nic: signature.

Signs1ture of Authorized Hepcesentatiye Date Signed

Submit completed applic~tion and supportihll docum:~lation to: [email protected]

If this application cannot besu~hlijted electronically, please contact Theresa Stabo, Angler R3 Coordinator, 608-577-6332.

Checklist: D Sign and Submit by Deadline

D Complete Response

D Complete Budget

D Authorizing Resolution

Save,.. I S~bmit by Email I

Angler Recruitment, Retention and Reactivation (R3) Project Proposal Form 8700-372 (2/18)

Does your project test new ways to train, develop, and educate anglers?

Explain:

Does your project effectively train mentors to commit to new anglers for a period of years through multiple introductions and educational experiences?

Explain:

Will this project result in producing new anglers who would not otherwise have had the opportunity to fish?

Explain:

How will that effect be measured?

Will the project measure and evaluate the effects of ot_her angler training _and development efforts?

Explain:

How will the benefits of this project be expanded to other areas of the state or other programs?

Save... I Submit by Email I

Page 3 of4

0 Yes O No

0 Yes O No

0 Yes O No

0 Yes O No

Sample Authorizing Resolution Instructions: Each respondent must submit to the DNR an Authorizing Resolution that is approved by the governing body of the organization and indicates which officers or employees of the organization are authorized to do the following:

1. Sign and submit the proposal 2. Sign the Agreement between respondent and the DNR 3. Submit annual and/or final reports to the DNR to satisfy the Agreement 4. Submit reimbursement request(s) to the DNR 5. Sign and submit other required documentation

We strongly recommend that respondents show title of position in the Authorizing Resolution, rather than name of employee. Employees have been known to retire or change jobs in the middle of a project. Were this to happen, your resolution would be ineffective. If your organization requires that a person be named in an Authorizing Resolution, then the resolution should also include contact information for the individual named.

Note: If respondent is required to submit a draft "intergovernmental agreement (/GA)" along with your proposal, an Authorizing Resolution is not a substitute for an /GA.

STANDARD AUTHORIZING RESOLUTION

WHEREAS, __ (respondent) __ is interested in obtaining a cost-share grant from the Wisconsin Department of Natural Resources for the purpose of _____________ (as described in the proposal);

WHEREAS, the respondent attests to the validity and veracity of the statements and representations contained in the proposal; ·

WHEREAS, an Agreement is required to carry out the project; and

NOW, THEREFORE, BE IT RESOLVED, that __ (respondent) __ will meet the financial obligations necessary to fully and satisfactorily complete the project and hereby authorizes and empowers the following officials or employees to submit the following documents to the Wisconsin Department of Natural Resources for financial assistance that may be available:

Task Title of Authorized Email address and phone Representative number if alternative is used

Sian and submit proposal Enter into an Aareement with the WDNR Submit annual and final reports to the WDNR to satisfy the Aareement, as annronriate Submit reimbursement request(s) to the WDNR per the Aareement

Sign and submit either documentation as necessary to complete the project per the AQreement

BE IT FURTHER RESOLVED that respondent will comply with all local, state, and federal rules, regulations, and ordinances relating to this project and the cost-share agreement.

Adopted on this ___ day of ______ ~ 20 __ .

I hereby certify that the foregoing resolution was duly adopted by ______ .at a legal meeting held on day of

-----~ 20 __ .

Authorized Signature _____________________ .Date _________ _

Title ______________ _

State of Wisconsin Department of Natural Resources PO Box 7921, Madison WI 53707-7921 dnr.wi.gov

Grant Partner Financial Data Report Form 9300-230 (R 12/17) Page 1 of4

Notice: The Department of Natural Resources (DNR) provided you with a grant that included funding from a Federal agency or another Wisconsin agency. So that the Department is in compliance with Uniform Guidance, we need you to complete the form below so that th~ Department may accurately report non-state funds that were used as match to the grant you received, including: cash contributions from your organization; Force Account labor; and donated labor, supplies, equipment, or equipment usage. Separate forms should be submitted with each reimbursement request that covers the same expenditure period as the reimbursement request. Failure to provide information requested may result in denial of grant funding to the Department. Personally identifiable information will be used for program administration and audit purposes and must also be available to requesters as required by Wisconsin Open Records Law [ss. 19.31 -19.39, Wls. Stats.J.

A. Grant Partner Information Leave Blank - DNR Use Onl Grant Recipient's Name Grant Project Title

Date (mmlddlyyyy) Grant Number

Is partner required to be audited under Single Audit Act: Expenditure Period (example: 0710112016 through 1213112016)

OYes O No

Instructions: 1. Salaries - applies to all Partners: Volunteer time provided by individuals may be listed as in-kind match at rates, including fringe benefits, consistent with those ordinarily paid for similar work. However, also attach documents that include (1) the name of the volunteer, (2) the dates worked, (3) the hours worked each day, and (4) a brief description of the work done.

2. Supporting Documentation: Provide supporting documentation, including time sheets, travel expense vouchers, vendor invoices, contract or grant agreements receipts or cancelled checks or other proof of actual expenditures

Category Expenditures Sponsor Match Value of Match Source

(Total Project Costs) Donations (Include only non-federal funds)

Salaries

Fringe Benefits

Travel

Supplies

Equipment

Contractual Services

Construction

Other (including land acquisition)

Indirect '

Total C. Cash Contributions to the DNR

Attach proofs of payment to support contributions listed in this section.

DNR Use Only

Date Amount DNR Account Code

Total Certification

To the best of my knowledge, I certify that the above is true and correct.

Print Name of Grant Recipient's Authorized Representative Title of Authorized Representative

Signature of Authorized Representative Date Signed

Maintain a copy for your records. Send original, signed and dated along with reimbursement request, to WI Department of Natural Resources.

Grant Partner Financial Data Report Form 9300-230 (R 12117) Page 2 of 4

D. Force Account Labor Summary Grant Recipient's Name

("Force Account Labor" is defined as local government staff paid with local governments funds and working on a grant project.)

Leave Blank - DNR Use Onlv Grant Project Title Grant Number

Employee Name Hourly Wage + Hourly Benefits

_ Total Wages - & Benefits

x Total Hours = Total Amount

+ = X = + = X = + = X = + = X =

Total Force Account Labor

Certification

I certify that the above force account labor was used for this project and that this claim is true and correct.

(Signature of Authorized Representative) (Date Signed)

E. Donated Labor Summary

Grant Recipient's Name

* Federal regulations 2 CFR 200 related to matching or cost sharing states: Unpaid se1Vices provided to a grantee or subgrantee by individuals will be valued at rates consistent with those ordinarily paid for similar work in the grantee's or subgrantee's organization. If the grantee or subgrantee does not have employees perfonning similar work, the rates will be consistent with those ordinarily paid by other employers for similar work in the same labor market. In either case, a reasonable amount for fringe benefits may be included in the valuation.


Description of Work Date Name of Volunteer Performed Hours Rate Total Signature of Volunteer

Total Donated Labor

Note: As an alternative to completing this page, you may attach a completed "Donated Volunteer Labor Worksheet" and/or "Donated Professional Service Worksheet". All donated labor worksheets must be signed by the donor.

Certification

I certify that the above donated labor was contributed for this project and that this claim is true and correct.

(Signature of Authorized Representative) (Date Sign~d)

Grant Partner Financial Data Report Form 9300-230 (R 12117) Page 3 of4

F. Donated Supplies Summary Grant Recipient's Name

* Federal regulations 2 CFR 200 related to donated supplies and loaned equipment or space states: ff a third party donates supplies, the contribution will be valued at the market value of the supplies at the time of donation.


Date Name of Donating Party Descriotion of Sunnlies Relation to Pro•ect Scone Value

Total Donated Supplies

Certification

I certify that the above donated supplies have been used for this project and that this claim is true and correct.


G. Donated Equipment Use Summary

Grant Recipient's Name

* Federal regulations 2 CFR 200 related to donated supplies and loaned equipment or space states: If a third party donates the use of equipment or space in a building but retains title, the contribution will be valued at the fair rental rate of the equipment space.


Name of Operator Type of Equipment Used Description of Work Date (Equipment) Performed Hours Rate Total

Total Donated Equipment Use

Certification

I certify that the donated equipment usage above was used for this project and that this claim is true and .correct.


Grant Partner Financial Data Report Form 9300-230 (R 12117) Page 4 of 4

Instructions

A. Grant Partner Information - Enter the Grant Recipient's Name and the Date on which this form was completed.

Background about Single Audit Act: The Single Audit Act of 1984 (Public Law 98-502) was passed by the US Congress to improve auditing and management for federal funds provided to state and local governments. A single audit is a cost-effective way to evaluate non-Federal entities, in lieu of audits from multiple federal agencies. This Act was further amended in 1996. The Act and 2. CFR Part 200 Uniform Administrative Requirements Cost Princio/es, and Audit Requirements for Federal Awards /referred to as Unifonn Guidance) provide audit requirements for ensuring that federal funds are expended properly. Federal funds may be disbursed as grants, contracts, loans, loan guarantees, property, cooperative agreements, interest subsidies, insurance, and direct appropriations from federal agencies. Rather than create a separate Wisconsin law that governs auditing of state funds provided to local governments, Wisconsin has chosen to follow the audit requirements of the federal Single Audit Act, as amended, and Unifonn Guidance.

All non-Federal entities that receive Federal and Wisconsin funds totaling at least $750,000 in a calendar year are required to hire a skilled auditor to evaluate compliance wjth the Single Audit Act, as amended, and Unifonn Guidance.

B. Grant Expenditures - Enter appropriate value for each of the expenditure categories.

• Salaries: Costs associated with fixed compensation periodically paid to a person for regular work or services. • Fringe Benefits: Costs associated with health insurance, group term life coverage, education reimbursement, childcare and

assistance reimbursement, cafeteria plans, employee discounts, personal use of a company owned vehicle and other similar benefits.

• Travel: Costs associated with reimbursement for work-related mileage, lodging, airfare, car rental, transportation fees (bus, taxi, train) and meals for grantee staff attending or conducting training sessions and travel expenses for guest instructors or presenters.

• Supplies: Cost of consumables used during the grant period. This includes such items as paper, toner cartridges, writing instruments, information and education materials, newsletters, maps and plats, personal computers costing < $5,000, software, printers, peripheral devices, and postage. Supplies do not include rental or capital expenditures.

• Equipment: Costs associated with purchase or rental of an article of tangible nonexpendable property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit.

• Contractual Services: Costs associated with work performed by an independent contractor requiring specialized knowledge, experience, expertise or similar capabilities. The grantee must have entered into a contractor agreement with the contractor for services.

• Construction: Cost of all construction portions of a project, generally based upon the sum of the construction contract(s) and other direct construction cost. This does not include compensation paid to the architect and consultants, the cost of the land, easements, right-of-way, or other related costs.

• Other: Other eligible costs associated with the completion of the grant project not listed above, including fee simple or easement land acquisition.

• Indirect: Costs not directly associated with a particular project, facility, function, or product. Indirect costs include administration, personnel, and security costs. Indirect costs are not eligible for reimbursement under the grant program nor can they be used as match to Federal grant funds.

Sponsor Match - Grants awarded by the DNR generally cover only a portion (50%, 70%, etc.) of the total project costs. This statutory requirement means that the balance of the project costs are paid by the project sponsor. The "Sponsor Match" column on page 1 is where the sponsor's portion of the total project costs should be noted.

Value of Donations - This column on page 1 is where all donations should be noted and summarized. Copy total from sections E, F, and Gin the appropriate field/cell.

C. Cash Contributions to the DNR - Money that is given to or earned by the grantee (i.e., proceeds from a car wash, bake sale, tree sale, donation jar, etc.) that is then placed in a DNR account to be used toward sponsor's grant project. DNR is acting as a bank in this capacity .

. D. Force Account Labor Summary - Total value of local government staff time paid with local government funds while working on this project.

E. Donated Labor Summary - Donated labor is assigned a cash value and documented in Section E to be counted as "in-kind match". If there are only a few volunteers, use the lines under Section E. If there are many volunteers, then each volunteer should complete their own donated labor sheet with each day's volunteer hours shown on a separate line. On donated labor sheet include volunteer date, name, hours worked, and volunteer's signature. If the donated labor is coming from a professional service provider, complete the Donated Professional Setvices Worksheet. For reimbursement, grant sponsors need to summarize all the volunteer sheets to obtain the total volunteer labor hours and then submit these hours along with copies of the donated labor sheets.

F. Donated Supplies Summary - Value of any donated supplies based on the market value of each item at the time of the donation. You may attach additional summary sheets if there aren't enough lines for all donated supplies.

G. Donated Equipment Use Summary - Information regarding any donated equipment. The value of the donation is the market rental rate for the equipment at the time of the donation. You may attach additional summary sheets if there aren't enough lines for all donated equipment. ·

Last revised: 15November2017

State of Wisconsin Department of Natural Resources Box 7921 Madison, WI 53707-7921

Grant Payment Request & Worksheet Form 8700-001 (R 11/17) Page 1 of4

Notice: Grantees are required to provide information requested on this form when applying for payment of a grant funded by the Department. The Department will not process your payment unless you provide all information requested. This information will be used to determine the amount of your payment and to issue your check. Personally identifiable information collected will be used for program administration and may be made available to requesters as required under Wisconsin's Open Records Law [ss. 19.31-19.39, Wis Stats.].

Submit one copy of the completed Grant Payment Request & Worksheet form, and required documentation, listed on reverse, to your DNR Grant Specialist. See the DNR web site for additional information: http://dnr.wi.gov/Aid.

" " • I ,. f " . . .. Grantee Name & County

Project Title Type of Request Q Partial O Final

Is this a land acquisition project? QYes @No Will in-kind donations be applied to this request?

QYes QNo

Did you receive a grant adVance or escrow? 0 Yes QNo Is this your first payment request? Q Yes QNo

The DNR will mail the check to the name identified on the application as the "Check Recipient." Contact your DNR Grant Specialist with questions.

Cost Share Summa Enter the percent state cost share listed in your grant agreement or identified in your approved grant application.

1. State Cost Share Percentage %

2. Grantee Cost Share Percentage %

Payment Record to Date Amount This Column for DNR Use Onlu

3. Total State Aid Amount (from Grant Agreement)

4. Total Payments Received (including Advance or Escrow)

5. Funds Remaining Reimbursement Calculation Information in this section is transferred from the Grant Payment Worksheet, page 3. Complete the Worksheet next. Note: Grant payment may not exceed the amount expended by the grantee as shown in the Cash Paid column of the Worksheet, and may not exceed the funds remaining in line 5 above. This calculation will adjust the state share and the grantee share for these conditions.

6. Total Eligible Project Costs this Period. Transferred from Worksheet

7. State Share of Costs

. 9. Amount Eligible this Claim

10. Grant Balance Remain in

Lake & River Grants Only: Does project include State Lab of Hygiene Sample Analysis? 0 Yes QNo

Certification I certify that, to the best of my knowledge and belief, the eligible costs requested are in accordance with the terms of the grant agreement and that all expenditures are based on actual payments of record. This reimbursement represents the grant share due that has not been previously requested.

Name of Authorized Representative - type or print (Area Code) Telephone Number

Signature of Authorized Representative (Area Code) FAX Number

Date Signed Email Address

Space Below this Line for DNR Use Only Grant Specialist Signature Reimbursement Approval Date

Grant Payment Request & Worksheet Form 8700-001 (R 11/17) Page 2 of4

INSTRUCTIONS

Grantee and Project Information

Identifies information about the grantee and project. Each field in this section must be completed before you will be able to complete the other sections of the form. Notes: 1. In-kind donations are defined as goods and services which have been provided to the project at no cost to the grantee and have documented valne. Examples include donated services, equipment, land, and volunteer labor. 2. If this is your first time submitting documentation of grant expenses, answer "yes" it is your first payment request.

Cost Share Summary Line I: State Cost Share Percentage. Enter this amount from your grant agreement. Line 2: Grantee Cost Share Percentage. This amount will autocalculate,

Payment Record to Date Line 3: State Aid Amount. Enter this amount from your grant agreement.

J,ine 4: If you answered "Yes" to question about receiving a grant advance or escrow and "Yes'' to this being the first payment after receiving your advance or escrow, then enter the advance or escrow amount on Line 4.

If you answered "No" to question about receiving a grant advance or escrow, or "No" to this being the first payment, enter onto Line 4 the total value of all payments received to date (include any advance or escrow received).

Line 5: Funds Remaining. This amount will auto-calculate as the difference between Lines 3 and 4.

Complete the "Grant Payment Worksheet", page 3, next. Follow these instructions to complete the Worksheet.

Reimbursement Calculation

Do not fill in this portion of the document. Amounts will either transfer from the Worksheet or auto-calculate.

Line 6: Total Eligible Project Costs this period. This amount will transfer from the Grant Payment Worksheet, page 3, and is the total of all eligible expenses claimed in the current payment request.

Line 7: State Share of Costs. This is the p01tion of project costs for which the state is responsible. This amount is the State Cost Share Percentage, Line I, multiplied by the Total Eligible Project Costs, Line 6. This amount is limited to the funds remaining in the grant, Line 5, or the amount expended by the grantee as shown in the Cash Paid column of the Grant Payment Worksheet. If this is the first payment request after receiving an advance or escrow, this amount may exceed the funds remaining, Line 5, if the amount eligible to be reimbursed after subtracting the advance amount is less than the funds remaining in line 5. This form will automatically adjust for these conditions.

Line 8: Grantee Share of Costs. This amount is the difference between the Total Eligible Project Costs and the State Share of Costs. Approved Reimbursement Amount

Line 9: Amount Eligible this Claim. This is the amount that grantee is claiming in this reimbursement request. Line I 0: Grant Balance Remaining. This amount will autocalculate as the difference between the Funds Remaining, Line 5, and Amount Eligible this Claim, Line 9.

In-Kind Donation Summary

If you answered "Yes" to the question about in-kind donations being applied to this request, a summary of the value of donation applied as grantee match will be included on page I, the Grant Payment Request.

Line 11: In-Kind Donations Applied to Claim. If more donations were applied to this claim than needed to meet the Grantee's share of costs, then in-kind donations applied to this claim is automatically calculated as follows:

In Kind Donations Applied ~

( Grantee Cost Share %) xState Share of Costs

State Cost Share %

Line 12: Remaining ID-Kind Donations. For some grant programs remaining in-kind donations may be applied to the next reimbursemerit request in the same grant agreement. On the next reimbursement request, you will need to enter the value from Line 12 of this worksheet into the ' 1In-Kind Donations" column on the worksheet of the next payment request. Include a project cost description of"remaining in-kind donations from the previous reimbursement". Ask your DNR grant specialist if you are eligible to use remaining in-kind donations on future reimbursement requests for the grant.

REQUIRED DOCUMENTATION Attach to the completed form one copy of the following documents as required by your grant program.

FOR LAND ACQUISITION PROJECTS:

1. Copy ofrecorded deed. 2. Copy of title insurance policy. 3. Copy of Gap insurance 4. Closing statement/canceled check(s). 5. Offer to purchase. 6. Proof of Just Compensation. 7. Statement of relocation payments, if any. 8. WI Department of Commerce relocation statement, if any. 9. Statement of program revenue; i.e., sale of buildings, etc.

FOR DEVELOPMENT PROJECTS: 1. Copy of invoices, vouchers and canceled checks. 2. Copy of bid specifications, certified bid tabulations, accepted

bid proposal(s), contracts and change orders. 3. Force account labor/equipment records. 4. Donation labor/equipment records. 5. Copy of affidavit of publication or bid notice.

FOR MAINTENANCE PROJECTS: 1. Copy of vendors invoices, vouchers and canceled checks. 2. Copy of bid specifications, certified bid tabulations, accepted

bid.

REPORTING REQUIREMENTS:

Use of this form is authorized either by Wis. Stats. or the Act for Federal Grant Programs. To view the exact citation, either go to the DNR web page for the grant program in question

http://dnr.wi.gov/Aid/Grants.html or see page one of the grant agreement.

Certification: This payment request cannot be processed unless this form is signed by the authorized representative named in your resolution. Questions? Contact your DNR grant specialist identified in the cover letter that came with your grant agreement. Or, go to the DNR web page for the grant program http://dnr.wi.gov/Aid/Grants.html and click on the Help tab.

State of Wisconsin Department of Natural Resources Community Financial Assistance

Grant Payment Request & Worksheet Form 8700-001 (R 11117) Page 3 of 4

Notice: Information requested on this worksheet is required by the Department when applying for reimbursement of eligible expenses. The Department will not consider your payment request unless you complete and submit this form and any required documentation.

Instructions: Itemize all project expenses, including donated labor, and attach photocopies of proof of expenses for each item listed. See reverse for instructions. Add additional lines to the worksheet as necessary, and number each printed worksheet. Submit with page 1 of the Grant Payment Request, Form 8700-001, or specific grant reimbursement fonm, to your DNR Grant Specialist.

Does this grant project include State Lab of Hygiene sample analysis costs? 0 YesO No

Grant Begin Date Grant End Date

GRANT PAYMENT WORKSHEET

~~r,,:

Total Project Cost: (Sum of Paid Subtotal and Donated Subtotal per this page)

.i, ti t f:6 <.,,.;;;•, ..• ··; 9i,c;itijl}f!rl?i<i,f!sf i$I~.::t#w0, , !&,R.!s{t. '.1 , •

, (S_ U_fTI_ .... • o_,_ ._f_._.•'R~jd/;8ub.tota.l/c1~clt;J',lp.~i!,tfidl!Subt<it.,,1,tor,:.all;page_s )< '-_/',,,•_-'',< />:•--,,'-_,,,,',,•,,,_'\,/'.-"','.','•,,',,,,,,,,,,,'-,,,•., .-.,,,- .. -.,,,,,-,

Project Sponsor/ Management Unit Name

Grant Number

Paid Subtotal Donated Subtotal

Grant Payment Request & Worksheet Form 8700-001 (R 11/17)

WORKSHEET INSTRUCTIONS

Page 4 of 4

Use the worksheet to itemize all project costs, including value of donated labor and donated expenses.

Attach photocopies of proofof purchase and payments for each item listed.

Add additional lines to worksheet as necessary by clicking on the"+" symbol located in the lower right comer of the Grant Payment Worksheet, page 3.

Worksheet_ Definitions

Date E4jense Incurred: Date of invoice, purchase, or service rendere ~ Costs incurred prior to the beginning date or after the ending date of the grant agreement are not eligible for re~mbursement, except as noted below.

• Exceptions: Certain land acquisition, design costs, and navigational aids may be reimbursable retroactively. Check with your DNR Grant Specialist.

Invoice#: Number on vendor invoice or bill associated with the purchase or service. · • Combined Costs: If an invoice combines costs for multiple grants

or expenses, identify and explain specific costs associated with each grant expense. Attach a copy of this invoice, as well as proof of payment identified below. Use as many lines as necessary.

• Donated Expenses: Inclnde invoice number if donated expenses are included on an invoice or bill. Otherwise, leave this field blank and go to "Proof of Payment#" column.

Proof of Payment#: Number on check or money order used to pay the expense. Ifno proof of payment number, leave blank. Attachments required: • Proof of Payment Examples:

Copy of canceled check (both sides) showing the amount of the check digitally printed by the bank under the signature line Non-cancelled check with bank statement showing check cleared account

Copy ofbank statement with vendor name and amount highlighted Connty payroll vouchers Credit card statement with supply or service vendor name and amount highlighted Receipts For acquisition expenditures, include a copy of the acquisition closing statement

• Combined Proofs of Payment: If a proofof payment covers multiple expenses or grants, identify payments related to the particular grant expense.

• Note: Redact (blacken out) account information submitted with proof of payment documentation.

• Donated Expenses: Volunteer Labor Worksheet, or other donated labor/services documentation. Include volunteer names, type of work, hours worked, pay rate and totals. Labor worksheets require signatures ofvolunteer(s)"and supervisor(s).

Payee: Name of consultant, contractor, vendor, supplier, etc. to whom payment was made.

Eligible Project Cost Description (See Grant Agreement): Describe expense briefly. Include only eligible expenses as specified in the particular project grant application and grant agreement.

Cash Paid: The amount of the project cost expense paid out-ofpocket by the grantee. Enter only actual expenditures in this column.

In-kind Donations: The value of donated services, labor, equipment usage, etc. Enter donated values in this column.

Paid Subtotal: The sum of all paid expenditures listed in that column.

Donated Subtotal: The snm of the value of each donated item listed in the colnnm.

Total Project Costs: (Paid Subtotals all pages)+ (Donated Subtotals all pages)~ Total Project Costs

• Automatically calculated and transferred to Page 1, Line 6 "Total Eligible Project Costs This Period" when form is completed electronically.

Certification: This payment request cannot be processed unless this form is signed by the authorized representative named in your resolution. Questions? Contact your DNR grant specialist identified in the cover letter that came with your grant agreement. Or, go to the DNR web page for the grant program http://dnr.wi.gov/Aid/Grants.ht.ml and click on the Help tab.

State of Wisconsin Department of Natural Resources (DNR) Division of Forestry PO Box 7921, Madison WI 53707-7921 dnrwi.gov

Volunteer Labor Worksheet & Summary Used as Grant Match Form 8700-349A (R 10/16) Page1 of2

Notice: Some DNR grant programs allow volunteer labor to count as the sponsor1s match to grant funds provided by the Department. If you have a grant from one of those programs and choose to use volunteer labor as part of your match, use this form to document volunteer labor. Personal information collected will be used for administrative purposes a~d may be provided to requesters to the extent required by Wlsconsin1s Open Records Law (ss. 19.31-19.39, Wis. Stats.).

Instructions: Completed form or form developed by sponsor showing the same required information .!llilfil be submitted with each reimbursement request (both partial and final) to verify volunteer labor.

Volunteer Last Name

Project Name:

.'Date·

*

• First

. : . - . -

Total Value of Services Periormed:

Rate is typically a flat rate set by admin. code, Federal Minimum wage, or WI minimum wage.

.... T<i+'!I · . X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X = .

I certify that the volunteer labor above has been performed and that this claim is true and correct. Note: If submitting this request electronically, please type your name on the signature line. Your typed name, along With the email message generated from electronic submittal of this form, will be used as an electronic signature which is the legal equivalent to an actual signature.

Type Name of Volunteer (In lieu of signature)

Volunteer Email

Date Signed

and/or Volunteer Phone Number

Volunteer Labor Worksheet & Summary Used as Grant Match Form 8700-349A (R 10/16) Page 2 of 2

Notice: Use this summary sheet to tally all volunteer labor donated per reporting period. This page will auto-populate totals from all page one worksheets completed electronically.

VOLUNTEER LABOR SUMMARY

Project Sponsor Grant Project Number:

Project Name:

. Name of Volunteer Hours . Rate Total

X = X = X = X = X = X = X = X = X = X = X = X = X = X = X = X = X = X =

Total Value of Services Performed = $

I certify that the volunteer labor above has been performed and that this claim is true and correct. Note: If submltting this request electronically, please type your name on the signature line. Your typed name, along with the email message generated from electronic submittal of this form, will be used as an electronic signature which is the legal equivalent to an actual signature.

I

Type Name of Authorized Representative __________________________________ _ (In lieu of signature) Date

State of Wisconsin Department of Natural Resources Division of Forestry

Donated Professional Services Used as Grant Match

PO Box 7921, Madison WI 53707-7921 dnr.wi.gov

Form 8700-350 (R 11/16) Page 1 of3

NOTICE: Some DNR grant programs allow donated professional services to contribute toward the sponsor's match. Donated services are valued at market rate. If you choose to use donated professional services as part of your match, you may use this form to document those values. The value of donated professional services maybe also be documented with an invoice from the donor on business letterhead, including the donor's name and professional title, name and number of the grant project the services are contributed to, dates of work, nature of work, and hours logged by date multiplied by hourly rate. The invoice should include a statement verifying the value of the services is being donated to the project, and must include the dono~s signature. Either an invoice or this completed form must be submitted with the grantee's reimbursement request. Personal information collect6d will be used for administrative purposes and may be provided to requesters to the extent required by Wisconsin's Open Records Law (ss. 19.31-19.39, Wis. Stats.) .

. • •• ' I • .. e • ' . •• Last Name I First IMI

IDNR Grant Project Number

Professional Title Project Name

Indicate the time interval covered by this report by Fiscal Quarterly Reporting O Rate selecting the option that is ·a best fit. Doing so will ~en calendars from which you can select start and end ates. Time Period Reporting O

Date Description of Work Performed Hours Rate* Total Signature of Donating Professional

X = X = X = .

X = X = X = X = X = '

X = X = X =

.·

X = X = X = X =

Total Value of Services Performed:

I certify that the donated services identified above have been performed by a professional.

Signature of Donating Professional Date Signed

I certify that the donated services have been performed and that this claim is fair and correct.

Sionature of Proiect Manaaer Date Sianed

Donated Professional Services Used as Grant Match Form 8700-350 (R 11/16) Page 2 of3

Notice: Use this summary sheet to tally all professional labor donation per reporting period. This page will auto-populate totals from all page one worksheets completed electronically.

Section 1.b DONA TED PROFESSIONAL SERVICES SUMMARY

Project Sponsor: IDNR Grant Project Number (from page one)

Project Name (from page one) Fiscal Quarterly Reporting 0 Time Period Reporting 0

.

Name of Professional Donating Services Hours Rate Total ·.

. x· =

.. . X . . = .

.

X . = .

X =

X = .

X =

X . =

X = . X =

X = .

X -. .

X =

X =

X = '

X -X =

·.· -,- ; .

X =

X =

Total Value of Services Performed: = $

I certify that the donated services identified in Section 1.a. have been performed and that this claim is fair and correct.

Signature of Project Manager ______________________ _ Date

Donated Professional Services Used as Grant Match Form 8700-350 (R 11/16) Page 3 of3

Notice: Professionals donating services to more than one DNR funded grant project during the reimbursement request time period must complete a Section 1.c. below to identified all hours, both paid and donated, contributed to those projects during the time period. It is recommended these reports be completed on a fiscal quarterly basis (Jan-March, April-June, etc.) to support quarterly, semi-annual, or annual reimbursement requests. Staff and Professional Service Providers contributing to multiple projects must submit a signed original of this form along with their invoice(s) or Donated Professional Services worksheet(s).

Professional Title:

Project/Grant Number

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

Fiscal Quarterly Reporting 0 Time Period Reporting 0

Total # Hours Services Provided

Certification: This report accurately reflects my professional wage/benefit rate and the number of hours I contributed to Wisconsin DNR grant-funded projects during the time period/fiscal quarter indicated. It identifies all Wis. DNR grant projects I contributed to during this period and is submitted so the value of these hours may be cost-shared or used as match for the grant project(s) indicated. Hours listed are specific to the grant project identified, and are not being billed toward or used as match for any other grant project funded by DNR.

Signature of Professional Service Provider ----------------------Date

Wisconsin Department of Natural Resources Bureau of Community Financial Assistance PO Box 7921

Angler R3 Program - Final Project Report

Madison, WI 53707-7921 dnr.wi.gov

Form 8500-165 (R 4/18) Page 1 of 2

Notice: Use of this form is required by the DNR to summarize your project. Personal information collected will be used for administrative purposes and may be provided to requesters to the extent allowed by Wisconsin's Open Records Law (ss. 19.31-19.39, Wis. Stats.).

Instructions: Fill out this form completely and mail it along with the Grant Payment Request & Worksheet (reimbursement request, Form 8700-001), Educational Outdoor Skills Activity Participant Report (Form 8500-166) and Authorized Mentors for Education Outdoor Skills Activity (Form 8500-167) to Jill Sunderland, WDNR, 810 W. Maple Street, Spooner, WI 54801. Please attach any other applicable supporting documentation. This form must be submitted within 60 days of the end date of the grant agreement or completion of the project, whichever occurs first.

Project Title

Project Focus ( check all that apply)

D Families

D Adult Anglers

D Youth (ages 10-15) D Multi-Cultural (non

Anglo Participants Long-Term New An ler Mentors . ' -

Total Number of Participants

Number of Family Groups

N/A

N/A

NIA.

Project Start Date

Nurnb~r of Number of Co.mments .• Fel)l~les Males .

What were the objectives of your projectand tiowdid you meelthose objectives? (Explain)

2 Outcomes Did participants gilln.kriowledge about fishing?

Explain howycilJknow this (e.g. pci~t'~rogram suryey): 0 Yes Q No

Did participants demonstrate that they gained skiils necessary for fishing?Q Yes O No Explain: · · · · ··

Did participants engage in a fishing outir,g? t · Explain:

0 Yes O No

What is the average number of hours that mentors will spend with novice participants? ___ Hours Explain:

How many times will mentors take novices fishing? times

Explain:

Project End Date

Angler R3 Program - Final Project Report Form 8500-165 (R 4/18) Page 2 of 2

Did participants buy a fishing license before participating in this project? 0 Yes O No Explain:

Did participants buy a fishing license after participating in this project? 0 Yes O No Explain:

3. Evaluations

Did you have participants complete evaluations for this project? If so, please summarize these evaluations here. (Please submit copies of completed evaluations with this completed form.)

4. Future Plans How will you follow up to ensure participants coritihUe to fish?

D I have completed cmd attached the EducatiorialQutdoor Skills Activity Participant Report (Form 8500-166).

D D

.. .

I have completed and attached the Aut_horized Mentors for Educational Outdoor Skills Activity (Form 8500-167). ::

I have completed and attached the Gr.int Payment Request & Worksheet (Form 8700-001 ).

By signing below, I certify to th~ best cifrny knowledge that the information contained in this report and all of its attachments is true and correct. · · ·

(Signature) Date Signed

(Print Name) (E-mail Address)

(Title)

Return to: Wisconsin DNR- Learn to Hunt Coordinator-LE/8 Bureau of Law Enforcement

dnr.wi.gov

101 S. Webster St. PO Box7921 Madison WI 53707-7921 [email protected]

Educational Outdoor Skills Activity Participant Report Form 8500-166 (R 2/15) Page 1 of2

NOTICE: This form listing the "novicen participants must be completed and in the possession of the lead mentor during the outdoor skills activity and submitted 2 weeks after the activity". Personally identifiable information will be used for administrative purposes and may be provided to requesters to the extent required by Wisconsin's Open Records law [ss. 19.31-19.39, Wis. Stats.]. "Novice participant" for hunting means any person who is 1 0 years old or o[der and/or has had less than 2 years of hunting experience. For trapping, it means a person who has no prior trapping experience as a Wisconsin licensed trapper. For fishing, it means any person who is 5 years of age or older who has [ess than 2 years of fishing experience. Activi Information ...... Outdoor Skills Activity !Date

0 Learn to Hunt O Learn to Fish O Learn to Trap

Species: D Bear D Waterfowl D Turkey D Deer D Small Game D Pheasant D Fish D Other.

Sponsor/Organizer Name Sponsor/Organizer Phone Number Multicultural event?

QYes O No

Toe sponsor/organizer of an Educational Outdoor Skills Activity must provide a list of names, including date of birth and DNR customer ID for each participant that took part in the above activity. Please print or type the participant's information below. NOTE: All participants, including volunteers and chaperones, must provide a DNR Customer ID Number to participate in an educational outdoor skills activity. Get your number by calling DNR's Customer Service at 1-888-936-7463 between 7 a.m. and 10 p.m. orvistt a DNR Service Center.

NOTE: Fishing· - This license waiver covers novices who are 16 years or older with less than 2 years of fishing experience and are engaged in this educational fishing activity. A volunteer or chaperone without a current fishing license may assist in the actual fishing activity, but must be listed below as a novice participant. Volunteers and chaperones with current fishing licenses should also be listed below.

iUllnhib Harvest Info

First Ml Last Name M/F DOB DNR Customer ID ILicense-(9 digtt# on license) YIN I Y/N Species or# of Fish

-- -- --

First Ml Last Name M/F DOB

-

.

Make additional copies if needed.

-

DNR Customer ID License-(9 digit# on license) YIN

.

YIN

Educational Outdoor Skills Activity Participant Report Form 8500-166 (R2/15) Page2of2

-- ---

Haivest Info

Species or# of Fish

State of Wisconsin Department of Natural Resources Bureau of Law Enforcement PO Box 7921, Madison WI 53707-7921 dnr.wi.gov

Authorized Mentors For Educational Outdoor Skills Activity Form 8500-167 (R 2/15) Page 1 of 2

NOTICE: This form must be completed and submitted as follows (NOTE: Mentors must have completed the Mentor Background Check Authorization for Outdoor Skills Programs application (Form 4100-217) and been authorized by the Bureau of Law Enforcement):

• Hunting (mentor must have 5 years hunting experience) = 2 weeks prior to any outdoor skills activity • Fishing = at the time of application

Personally identifiable information will be used for administrative purposes and may be provided to requesters to the extent required by Wisconsin's Open Records law [ss. 19.31-19.39, Wis. Stats.].

Outdoor Skills Activity 0 Learn to Hunt O Learn to Fish O Learn to Trap

Species D Bear D Waterfowl D Turkey D Deer D Small Game D Pheasant D Fish D Other:

Sponsor/Organizer Name Sponsor/Organizer Phone Number

The sponsor/organizer of an Education Outdoor Skills Activity must provide a list of names, including DNR customer ID and phone number for each mentor who will be assisting in the above activity. Reimbursement will not be given unless DNR customer ID is given for each mentor listed below. Please print or type the mentor's information below. NOTE: If applicant/sponsor is also participating as a mentor his or her information must be included below. Mentor Information

DNR Customer ID First Ml Last Name M/F (9 digit# on license)

IT more space 1s neeaea, p1ease copy 1s page as a mank berore rmmg and attach completed pages as necessary.

Send completed application for Educational Outdoor Skills Activity to:

Outdoor Skills/L TH Coordinator - LE/8 DNR Bureau of Law Enforcement 101 S. Webster St., PO Box 7921 Madison, WI 53707-7921 [email protected]

Phone

Mentor Information

First Ml Last Name

7f more s ace ts neeclecJ )/"ease co 1s a e as a blank Delore fill!n and attach com 1Jeted p ,p PY P 9 g p

Send completed application for Educational Outdoor Skills Activity to:

Outdoor Skills/L TH Coordinator - LE/8 DNR Bureau of Law Enforcement 101 S. Webster St., PO Box 7921 Madison, WI 53707-7921 [email protected]

Authorized Mentors For . Educational Outdoor Skills Activity Form 8500-167 (R 2/15) Page 2 of2

DNR Customer ID M/F (9 digit# on license) Phone

a es as necessa p g ry

Sample Angler R3 Grant Agreement

Placeholder for agreement format to be developed.

draft guidance: angler recruitment, retention, reactivation (r3) … · 2018-05-15 · angler...

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