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Home
About
Services
Careers
Contact
Forms
ASF Info Form
ASF Detail Form
Home
About
Services
Careers
Contact
Forms
ASF Info Form
ASF Detail Form
ASF Detail Form
ASF Detail Form
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Name of the Organization (Legal)
*
Doing Business As (DBA)
*
Year Original Facility Was Built
*
501(3)(c) (need a hard copy)
Yes
No
Federal EIN # (same as 501c3)
*
UEI number/registration through SAMS.GOV website
*
Website / URL
*
Address
*
Address Line 1
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Municipality and County
*
Organization type (religious, educational, medical, other)
*
Mission Statement (500 Character or Less):
*
Additional sites and locations (if applicable)
Addresses for additional sites (also include building, Parking lot, Imam house etc…)
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Head of the organization
Email
Title
Phone #
Is your site historic?
Have you had a Security Assessment Vulnerability (SAV) completed?
Yes
No
If SAV not completed, have you done a facility self-assessment?
Organization’s ideology, beliefs and mission
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Points of contacts( Including Project Manager)
Email
Phone
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Contact #2
Email
Phone
Layout
Contact #3
Email
Phone
Layout
Authorized Signatory
Email
Phone
Have you ever had any terrorist attack?
Have you ever had any bias incidents?
Are you aware of any terrorist / bias incident within your county?
Do you have relationship with your local and county law enforcement?
Yes
No
Has your local law enforcement conducted a walk through in case for active shooter?
Yes
No
Have you ever applied for the Federal Emergency Management Agency (FEMA) non-profit security grant program?
Yes
No
If you have applied for the (FEMA), When did you apply? What were the results?
Have you ever applied for the New Jersey non-profit security grant program?
Yes
No
If you applied for the New Jersey non-profit security grant program, When did you apply? What were the results?
How many members are in your congregation?
On average, how many people come to worship besides major holidays?
How many people attend services during your major Holidays’ celebrations?
What other services besides worship your organization provides to the community? (for example: soup kitchen, recreational, facility rentals, festivals..etc.)
Do you currently have the emergency operation plan (EOP), which covers all hazards in place?
Is your site a shelter for natural or manmade disasters?
Is your location used as a poll station?
Do you have a daycare or after school program on your site?
Yes
No
If you have a daycare or afterschool program on your site, How many children attend?
Do you have a private school on your site?
Yes
No
If you have a private school on your site, How many children attend? What are there grades?
Do you conduct religious classes/studies on your site? (weekend school)
What is the estimated size/square footage under your site?
What are your current security concerns?
How would you like to spend your grant money? (security cameras, exterior lights, fence, security film, exterior doors, locks, generators, PA system, portable radios etc…) list by priority
What are any additional concerns or comments you have?
Are you part of local interfaith group?
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