 | | Legal name of organization, address, name of executive director, and contact person other than |
| | executive director.
|
 | | Telephone number, fax number and email address.
|
 | | Amount requested.
|
 | | Please summarize in a short paragraph your funding request and indicate the type of request |
| | (operating, project, capital, other).
|
 | | List any previous support from The Foundation.
|
 | | A brief description of its history and mission.
|
 | | Current programs and accomplishments.
|
 | | Overview of organization's structure including the number of full- and part-time staff as well as |
| | volunteer involvement.
|
 | | Total organizational budget and fiscal year end.
|
 | | Describe your organization's constituents including the total number and breakdown by age, |
| | gender, race/ethnicity, income levels, disabilities, and geography.
|
 | | Funding Request — Please describe the program for which you seek funding, addressing each of |
| | the following:
|
 | | Program strategies
|
 | | Target population
|
 | | How many people will benefit from the proposed project? Please give specific numbers if |
| | possible.
|
 | | Specific activities and timetable for meeting your stated objectives.
|
 | | How does the project contribute to your organization's overall mission?
|
 | | What do you ultimately hope to accomplish through your proposed project?
|
 | | What are your plans for fully funding and sustaining this program?
|
 | | What other agencies or associations are you working with on this project?
|
 | | How will you measure and monitor the program's progress and effectiveness?
|
 | | What relevant assets and experience does your staff bring to this project?
|
 | | Describe your criteria for a successful program and the result you expect to achieve by the end of |
| | the funding period.
|
 | | IRS 501 (c)(3) Tax Determination Letter.
|
 | | Most recent financial statement, audited if available.
|
 | | Most recent 990 Form filed with the IRS.
|
 | | Operating expense budgets for current and most recent fiscal year.
|
 | | List of public/private funding sources for your organization during the past fiscal year.
|
 | | If project funding is requested, please include:
|
 | | Current expense budget for the project.
|
 | | List of all sources of income for the program including committed and prospective, with amounts.
|
 | | Specific uses of the requested grant, if possible.
|
 | | List of Board of Directors, with affiliations.
|
 | | Current Annual Report, if available.
|
 | | Organization contact name, address, phone, fax, and email address.
|
 | | Three letters of reference from other organizations and/or individuals you are currently working |
| | with or have worked with in the past. This may include one or two parents whose children have participated in your programs.
|
 | | Optional: brochures, newsletters. |
| | |