This form is designed to be simple and flexible. If you need help at any point, please contact Noelani Villa, noelaniv@uw.edu or schedule an online meeting or phone call. 

Download a printable PDF here

Section 1: Applicant Information

Name of Tribe:

Project Primary Contact Name:

Title/Role:

Email:

Phone Number:

Authorized Representative Name:

Title:

Email:

Phone Number:

Section 2: Project Overview

Project Title:

Project Start Date: October 17, 2025

Project End Date: September 30, 2027

Project Summary (2–3 sentences):

Section 3: Scope of Work

Describe what your project will do and who will be involved. Describe your Tribe’s climate resilience goals or community understanding of climate resilience and how your proposed project supports them. 

Consider the following prompts to guide your response:

• What are your Tribe’s climate resilience goals and/or how does your Tribe define climate resilience?
• How does this project support those goals or definitions?
• What is the main objective of your project?
• What specific activities will you carry out? 
• Who will lead and participate in the work? 
• Where will the work take place?
• What will be the final outputs and outcomes of the work?

Example Scope of Work Statements

Example 1: Adaptation Planning

The Coastal River Tribe defines climate resilience as the ability to protect our lands, waters, and cultural lifeways from the impacts of climate change, while strengthening our community’s capacity to adapt and thrive for future generations. This project supports our definition by helping us understand the risks we face from sea level rise and coastal erosion, and by creating a plan that reflects our values and priorities for protecting our homelands. The main goal of our project is to develop a comprehensive climate adaptation plan that prepares our community for future environmental changes. We will hold community listening sessions, map areas at risk, and draft a vulnerability assessment and adaptation plan with input from Tribal members and staff. The project will be led by our Natural Resources Department, with support from the Tribal Council, Elders, and youth representatives. The work will take place on our reservation lands and adjacent coastal areas. This project will help us identify the most urgent risks, prioritize actions, and secure future funding to implement protective measures.

Example 2: Youth Engagement

The Mountain Valley Tribe defines climate resilience as the ability of our people—especially our youth—to carry forward traditional knowledge and lead efforts to protect our environment in the face of climate change. This project invests in our youth as future leaders by giving them tools, mentorship, and cultural grounding to understand and respond to climate impacts. The main goal of our project is to launch a summer internship program that engages high school students in climate education, cultural learning, and hands-on environmental work. Activities will include workshops on climate science and traditional ecological knowledge, field trips to restoration sites, and mentorship from Elders and environmental professionals. The Education Department will coordinate the program, with support from the Cultural Committee and Natural Resources staff. Activities will occur at the Tribal community center, local rivers and forests, and nearby partner organizations. This project builds long-term capacity by preparing the next generation to lead climate resilience efforts rooted in both science and cultural values.

Section 4: Project Activities and Timeline

Please provide a comprehensive timeline of your project’s planned activities and milestones. This section is intended to demonstrate the structure and feasibility of your proposed work. You may present the timeline in narrative form, as a table, and/or in bullet points – whichever format best communicates your approach.

Example 1: based on the adaptation planning example scope of work

Section 5: Budget

Example 1: based on the adaptation planning example scope of work

Please complete the table below or attach a separate budget file using the provided template. These are example categories; please edit as needed and provide estimated costs. 

Section 6: Budget Justification

Please provide a brief explanation for each cost category listed in the budget table above. 

Example 1: based on the adaptation planning example scope of work

SALARIES AND WAGES: $23,000

$23,000 to support a dedicated Project Coordinator (0.5 FTE) to oversee overall management and successful execution of the project. This position will be responsible for overseeing all phases of work. Responsibilities will include securing venues, developing invitations, conducting outreach for listening sessions, coordinating with community members for feedback, facilitating the acquisition of GIS and environmental data for risk mapping, coordinating the development of risk maps, and supporting the establishment of the advisory and lead groups for the vulnerability assessment. Includes fringe benefits for the Project Coordinator at 30%

RETIREMENT & BENEFITS: $6,900

$6,900 to support fringe benefits for Project Coordinator ($23,000 x 30%)

OTHER DIRECT COSTS: $9,800

• Honoraria: $2,000

$2,000 to support honoraria in the form of gift cards (80 gift cards @ $25 each) will be provided to 80 community members participating in the “Community Listening Sessions” (November 15, 2025 – January 18, 2026). These sessions are crucial for gathering essential community priorities and insights to inform the risk mapping and the overall vulnerability assessment. Providing honoraria is a way to acknowledge and compensate participants for their valuable time, knowledge, and contributions to the project.

• Stipends: $7,000

$7,000 to support stipends (14 @ $500 each) to 14 key community members who commit to extended engagement and participation as part of the “Advisory Group” established during the “Draft Vulnerability Assessment and Adaptation Plan” phase. This group will gather input from Tribal Council, elders, and youth, and will be critical in reviewing the draft plan. These stipends recognize the significant time commitment and expert knowledge these individuals will contribute throughout the planning and review process.

• Venue Fee: $800

$800 to host a one-day community event for 4 hours ($200/hr x 4 hrs). This venue will primarily be used for the “Community Listening Sessions” providing an accessible and appropriate space for community engagement and feedback collection.

INDIRECT COSTS: $11,910

$11,910 in indirect costs ($39,700 in direct costs x 30% indirect cost rate for the X Tribal Nation). 

Section 7: Reporting 

Please describe how you plan to report on your project’s progress. You may choose one or more of the following methods:

• Storytelling
• Visual reporting (e.g., maps, photos, artwork)
• Written report
• One-on-one phone call with the program manager
• Community surveys or testimonies (e.g., “witnessing” in Coast Salish traditions)
• Other (please describe)

Using one or more of the above methods, all grantees must submit the following:

• Mid-project update (no later than September 30, 2026)
• Final report within 60 days of project completion (but no later than November 30, 2027)