Organization’s mission and primary activities:
Organization’s historical/institutional memory:
Number of paid employees:
Number of FTE (full time equivalent):
Fringe benefit costs:
Number of volunteers:
Volunteers (# of people and hours) per year/month/week:
Number of board members:
Number of board members who contribute to annual budget:
Number of board meetings per year:
Breakdown of organization revenue for the last year:
Earned Income (Ticket sales, fees for service, etc.):
Organization's unrestricted cash reserves at beginning of current year:
What is your administrative overhead? Indirect costs? %?
Do you receive funding from the government? United Way? How much?
List of five single largest contributors from last year’s revenue sources:
Project contact person's information:
Project description (one sentence):
Key project components:
How many persons will benefit directly from the project?
What specific group(s)---youth, elderly, homeless, disabled, immigrant, LGBT…….?
Is the project for which you are requesting funds intended to benefit the general public, or is it intended to reach a specific population group?
Total project budget:
Total amount requested:
Is this a multi-year request? Not all grant programs accept multi-year requests.
Please list all proposed sources of funding. You may include the value of in-kind support. Please indicate whether or not the funding has been secured.
Please list all budgeted expenditures. Project expenses listed here should correlate to project activities.
Please describe how funds would be allocated for the project.
Tell us about your organization. What are your mission and track record?
Highlight two or three key facts and accomplishments that best define your organization.
What need does your project address?
What critical community problem needs to be addressed or what organizational capacity are you hoping to build?
What do you propose to do about this need?
What is your plan for addressing this need?
What are your goals? Please be concrete.
How will you do it?
When and with whom?
What are the specific activities to be supported?
How long will they take?
If your project involves partnerships with other organizations, have the proposed partners agreed to participate?
Who is responsible for your project?
Briefly describe your project leaders and the role that each will play in the project.
How do these leaders reflect the population or community that you serve?
How will you measure results?
What will success look like?
How will you measure or document project success or impact?
Please outline your evaluation plan.
What is your plan for securing the balance of the project budget?
What is your fundraising timeline?
If other potential resources cannot provide all of the support requested, what will you do?
How will you sustain the proposed activities or build on what you achieved?
Please describe your plan for securing the financial, human and in-kind resources needed to sustain or build on project achievements.
Mother, Jewish, mostly raw/vegan, teacher, curriculum developer, grant writer, flower essence maker, dual US/Israel citizen, friend, dancer, lover of life.