<p> THE MAINE WOMEN’S GIVING TREE</p><p>Grant Program - 2017</p><p>Grant Application Form</p><p>Name of Organization ______</p><p>E Executive Director ______</p><p>A Address ______</p><p>__</p><p>PT Telephone ______Fax ______</p><p>W Website______Email ______</p><p>PaParent Organization if different______</p><p>Na Name of Program for which funding is requested______</p><p>A Amount of Grant Request ______Total Program Budget______</p><p>Date Program Will Begin______Date Program Will End______</p><p>PgProgram Director/Contact ______Title______</p><p>PhPhone ______Email______</p><p>Si Signature of Executive Director ______Date______Please attach Grant Proposal (4 pages maximum) that must address the following:</p><p>ORGANIZATION MISSION STATEMENT should head the program narrative.</p><p>GRANT DESCRIPTION </p><p>1. Provide a one paragraph abstract describing your organization and the program for which you are seeking funding. 2. Tell why the program is needed, and how it will help your organization meet its mission. 3. Which of the following categories describes the program for which you request funding?  Seed or New Program: discuss the need for this new program and how, if funded, the program will strengthen the organization’s mission. How will this program be funded in the future?  Enhancement of a Current Program: explain how augmenting or enhancing this program will contribute to strengthening the mission of the organization.  Continuation of an Existing Program: discuss how this program has made an impact and what the impact of its loss would be. 4. Describe the proposal’s target population (number to be served, ages, and locations). 5. What is the projected 12-month timeline (MWGT funding begins on July 1)? 6. How will you measure the outcomes of the proposed program? 7. Which capabilities of your organization can ensure the success of the proposed program? 8. How does the program meet the mission of the MWGT?</p><p>REQUIRED ATTACHMENTS: please note that these attachments are not included in the 4-page proposal limit. Include:</p><p> A brief history of your organization  How the program will be staffed and managed. Identify possible barriers to success and how they might be addressed; include a bio sketch of the key personnel who will be staffing the program  Required Program Budget Form (form is included in application packet)  The organization’s total operating budget for the most recently completed fiscal year. If this is a continuation proposal, also include the actual and budgeted expenses to date of the program for which you seek funding  How the organization will disseminate information about the proposed program and its impact and how the MWGT will be acknowledged  Current IRS documentation of 501 (c) (3) status and Federal ID number</p><p>Send 3 hard copies of the grant proposal with required attachments to:</p><p>The Maine Women’s Giving Tree PO Box 1065 Brunswick, ME 04011</p><p>Submit 1 electronic PDF copy with attachments to: [email protected] </p><p>Applications must be received no later than close of business on Friday, February 3, 2017. Applications received later will not be considered. MAINE WOMEN'S GIVING TREE REQUIRED PROGRAM BUDGET FORM</p><p>Organization name:______</p><p>Project name:______</p><p>Date project begins:______Date ends:______</p><p>(MWGT funding begins July 1, 2017) </p><p>Grant Personnel (list titles below; use Cost Amount requested Amount from Total project cost additional pages if needed) from MWGT other sources *</p><p>Sub-total personnel (A) Other project direct costs**</p><p>Sub-total other direct costs (B) Total cost A&B</p><p>*Total requested from both MWGT and other funding sources ** These include such things as supplies, travel, equipment, printing, mailings, rental fees, other</p><p>Please attach a page with the following budget information: 1. Give details describing each program expense requested 2. If you listed non-MWGT support, has that funding been committed? If not, has it been requested and when will funding be available? 3. Describe any in-kind support available for this program (organization, volunteer, etc.) THE MAINE WOMEN’S GIVING TREE</p><p>Grant Program – 2017</p><p>Grant Application Review Criteria </p><p>Reviewers use the criteria listed below in their grant evaluations. They are included here for your information.</p><p>CRITERION 1: NEED (30 Points)</p><p>Does the applicant:</p><p>1. Provide a compelling rationale with relevant documentation that supports the need for the proposed project/program?</p><p>2. Clearly define the target population and provide a plan to engage them?</p><p>CRITERION 2: IMPLEMENTATION (30 Points)</p><p>Does the applicant:</p><p>1. Identify adequate staff with relevant qualifications to implement the project/program?</p><p>2. Propose a reasonable time frame to implement the project/program?</p><p>3. Have adequate resources i.e. facilities, materials, supplies to implement the project/program?</p><p>CRITERION 3: EVALUATION (20 P0ints)</p><p>1. Does the applicant propose a method to assess the progress and outcomes of the project/program?</p><p>2. Will MWGT funding for this project/program significantly impact the target population in our community? </p><p>CRITERION 4: BUDGET (20 Points)</p><p>1. Does the applicant provide budgeted revenues and expenses that reflect the effective use of the funds requested including a detailed description of each line item?</p><p>2. Does the budget include any in kind or additional funding from outside sources?</p>