Welcome to the State of California 

2012-2014 Funding Application 

Local agencies must complete the funding application, using the Contract Management Binder (CMB)Opens a new browser windowas a reference. 

Refer to the Funding Worksheets emailed on August 19, 2011 for caseload and funding authorizations.

Return your complete funding application to your Regional Advisor as soon as possible, but no later than August 31, 2011, to ensure your contract is executed before the end of the fiscal year.

  • Funding Application Cover (PDF)Opens a new browser window
  • Instructions for Completing Funding Application (PDF)Opens a new browser window
  • Attachment 1-1 (WORD)Opens a new browser window- Required Documents Check Off List 
  • Attachment 1-2 (WORD)Opens a new browser window- Certification of Application
  • Attachment 1-3 (WORD)Opens a new browser window- Basic WIC Local Agency Information
  • Attachment 1-4 (WORD)Opens a new browser window- Languages Spoken by Participants and Staff
  •  Instructions for Attachment 1-5 through 1-7 Funding WorksheetsOpens a new browser window
  • Attachment 1-5 through 1-7 (EXCEL)Opens a new browser window- Sample Funding Worksheet
  • Instructions for Attachment 1-8 through 1-10 Personnel Justification Worksheet (PDF)Opens a new browser window 
  • Attachment 1-8 (EXCEL) Opens a new browser window- Personnel Justification Worksheet Year 1
  • Attachment 1-8 (EXCEL)Opens a new browser window- Personnel Justification Worksheet Year 1 Continuation Form
  • Attachment 1-8a (WORD)Opens a new browser window-  Justification of Staffing Levels
  • Attachment 1-9 (EXCEL)Opens a new browser window- Personnel Justification Worksheet Year 2
  • Attachment 1-9 (EXCEL)Opens a new browser window-  Personnel Justification Worksheet Year 2 Continuation Form
  • Attachment 1-9a (WORD)Opens a new browser window-  Justification of Staffing Levels
  • Attachment 1-10 (EXCEL)Opens a new browser window-  Personnel Justification Worksheet Year 3
  • Attachment 1-10 (EXCEL)Opens a new browser window-  Personnel Justification Worksheet Year 3 Continuation Form
  • Attachment 1-10a (WORD)Opens a new browser window- Justification of Staffing Levels
  • Instructions for Attachment 1-11 through 1-13 Operating Expenses Budget Detail Opens a new browser window 
  • Attachment 1-11 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 1
  • Attachment 1-11 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 1 Continuation Page
  • Attachment 1-12 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 2
  • Attachment 1-12 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 2 Continuation Page
  • Attachment 1-13 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 3
  • Attachment 1-13 (EXCEL)Opens a new browser window- Operating Expenses Budget Detail Year 3 Continuation Page
  • Attachment 1-14 through 1-16 Capital Expenditures Budget Detail InstructionsOpens a new browser window 
  • Attachment 1-14 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 1
  • Attachment 1-14 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 1 Continuation Page
  • Attachment 1-15 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 2
  • Attachment 1-15 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 2 Continuation Page
  • Attachment 1-16 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 3
  • Attachment 1-16 (EXCEL)Opens a new browser window- Capital Expenditures Budget Detail Year 3 Continuation Page
  • Instructions for Attachment 1-17 through 1-19 Subcontracts Budget DetailOpens a new browser window 
  • Attachment 1-17 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 1
  • Attachment 1-17 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 1 Continuation Page
  • Attachment 1-18 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 2
  • Attachment 1-18 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 2 Continuation Page
  • Attachment 1-19 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 3
  • Attachment 1-19 (EXCEL)Opens a new browser window- Subcontracts Budget Detail Year 3 Continuation Page
  • Additional Forms
  • Attachment 1-20 (WORD)Opens a new browser window- Request for Authorization to Subcontract
  • Attachment 1-24 (PDF)Opens a new browser window-  Drug-free Workplace Certification (STD 21)
  • Attachment 1-25 (PDF)Opens a new browser window- Certification Regarding Debarment
  • Attachment 1-26 (WORD)Opens a new browser window- Payee Data Record Form (STD 204)
  • Attachment 1-27 (PDF)Opens a new browser window- Contractor Certification Clauses (CCC-307)
  • Attachment 1-28 (PDF)Opens a new browser window- Certification Regarding Lobbying
  • Attachment 1-29 (WORD)Opens a new browser window- Disclosure of Lobbying Activities
  • Attachment 1-30 (PDF)Opens a new browser window- Nondiscrimination Certification
  • Attachment 1-31 (WORD)Opens a new browser window- Civil Rights Report
  • Attachment 1-32 (PDF)Opens a new browser window- Sample Prospective Payment Letter
  • Attachment 1-33 (WORD)Opens a new browser window- Full use of federal funds
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    Last modified on: 8/29/2011 1:07 PM