Template for Simple Application

Yates Community Endowment – Grant Application The Community Foundation 500 East Avenue Rochester, NY 14607 www.racf.org

The Yates Community Endowment Advisory Board is a volunteer panel of community-minded Yates County residents who are knowledgeable about community needs and dedicated to improving the quality of life in Yates County.

The Advisory Board, on behalf of Rochester Area Community Foundation, is accepting applications from charitable organizations whose efforts strive to improve the quality of life and contribute to the strength of the local economy in Yates County. Preference will be given to collaborative projects or programs that leverage other resources and create a long-term positive impact on Yates County. The Advisory Board seeks to award grants that, as a group, will benefit a diversity of populations, purposes and geographic areas within Yates County. Grants will be awarded from the Yates Community Endowment Fund and the Robert F. Flickinger Memorial Fund of the Yates Community Endowment.

Criteria and eligibility guidelines:  Applicants must be a 501(c)(3) organization or sponsored by a charitable, nonprofit organization;  Funds must be used in Yates County and benefit Yates County residents;  Successful applications will:  Focus on an unmet need  Address an important quality of life and/or economic development issue  Offer broad community benefit  Be rooted in the local community and build on local strengths  Be preventive rather than remedial  Avoid duplication with other programs or services  Applicants must demonstrate that the project can be sustained if the project is expected to continue beyond the grant period; and  Applicants must be able to measure the project’s success and its results in the community.

Grants will NOT support:  Individual Yates County residents;  Debt reduction;  Religious activities, although non-religious activities provided through religious institutions are eligible for consideration; or  Endowment campaigns.

Grant size: Grants will typically range between $1,000 and $5,000. Grants under $1,000 will be considered.

Proposal due date: Applications must be submitted online by 5pm on Monday, March 16, 2015. Awards will be announced in late May.

Joy Benson, Regional Coordinator The Community Foundation 500 East Avenue Rochester, NY 14607 (585) 341-4412

Yates Community Endowment Application Form [email protected] How to submit an application:

1. Complete the enclosed Applicant Organization Information Sheet for the organization submitting the request and the Program/Project Budget Sheet for the proposed project for which you are seeking funding. Provide a brief budget narrative to explain the budget. Do not staple documents or submit items in folders or binders.

2. Answer the following questions (A - F) as specifically as possible in four typed pages or less. Do not repeat information from one section to another:

A. Need and Demand 1. Summarize the need for your proposed project. Cite any research documenting the need, if possible. 2. Summarize customer demand for your proposed project. (Waiting lists, unfulfilled requests, etc…). 3. Demonstrate how the project meets the grant criteria.

B. Outcomes 1. What do you expect to achieve through this project? 2. How will you measure your progress and determine if you have reached your goals/desired outcomes? 3. When will you achieve the outcomes?

C. Project Description, Resources & Activities 1. Describe what you propose to do, how you will do it, and the resources that you will access or use.

D. Organizational Capacity 1. What is your organization’s mission and how does this project relate to it? 2. Describe experiences you have in implementing similar projects. If your organization has no similar experiences, please explain why you are qualified for this undertaking.

E. Links with other agencies 1. Provide the names and roles of collaborative partners, if any. Include letters of support if relevant.

F. Future 1. What is the future of this project beyond the grant period? 2. If it is to continue beyond the grant period, how will you support this project?

3. Provide the following four items with your completed application:

1. One copy of the IRS determination letter advising that your organization is exempt from taxes under Section 501(c)(3) of the IRS code and that the organization is not a private foundation as defined in Section 509(a);

2. A list of the organization’s Board of Directors with their affiliations;

3. A financial summary of your organization’s most recently completed fiscal year, including the original budget and actual revenue and expenses for that year; and

Yates Community Endowment Application Form 4. An Annual Report. YATES COMMUNITY ENDOWMENT APPLICATION THE COMMUNITY FOUNDATION

APPLICANT ORGANIZATION INFORMATION SHEET

Name & address of applicant organization: Is the name at the left the same as it appears on the IRS 501(c)(3) Letter of Determination? __yes __no If not, explain: For current fiscal year: Telephone number: Organization’s total budgeted revenue:

Fax number: Organization’s total budgeted expenses:

E-mail: Fiscal year: ______to ______

Revenue Sources for organization: Chief Executive Name and Title: ___ % government (city, ___ % fees county, state, ___ % grants federal) ___ % investment 9-digit Federal Employer ID #: ___ % United Way income ___ % membership ___ % fund raising Year organization incorporated: (e.g. events, gifts, bequests, etc.)

Information for This Request

Name of this program or project: List other potential and actual sources of support - put an “*” by those committed, noting any matching fund requirements. Program/project contact person: Amount Funder Name:

Phone number:

Total cost of this effort:

Amount requested from this funder:

Type: __Capital __ Construction __ Renovation __ Equipment List major funders of this program/project for __Program/Project past two years if applicable: __General Support Amount Funder __Other (describe)

Date funds needed by:

Date by which funds will be spent:

Yates Community Endowment Application Form YATES COMMUNITY ENDOWMENT APPLICATION THE COMMUNITY FOUNDATION

PROGRAM / PROJECT BUDGET SHEET

Provide the requested information for the program or project for which you are seeking this grant.

SUPPORT / REVENUE Total Anticipated Support/Revenue Requested grant per this application Fundraising or special event revenue Other foundation or corporate grants Government grants or contracts United Way support Other contributions Fees for service Sales revenue Membership dues Investment income

TOTAL Support/Revenue

EXPENSES Total Expenses for Expenses to be Program/Project Covered by Requested Grant Salaries Fringe benefits Professional fees (contracts, consultants) Evaluation Training Travel/meeting expenses Occupancy Phone, fax, information technology Printing/postage Supplies (consumable) Equipment Subtotal: Direct Expenses Proration: General/Management Overhead TOTAL Expenses

Include a brief budget narrative of no more than one page to explain your budget (i.e. number of staff, type of consultant, number of trainings, etc.).

Yates Community Endowment Application Form