ROI Grants Sample Application Form Page Name Roi Israel

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ROI Grants: Sample Application Form Page 1/2 1. 2. 3. 4. 5. 6. 7. 8. Name: Roi Israel ROI Year: 2006 Email: ROI@roi120.com Snail Mail: 234 Rehov Simta Tel Aviv, Israel Telephone Number: +972.3.1234567 Mobile: +972.54.1234567 Project Name: Global Jewish Grants Is the project being hosted by a non-profit/charitable organization? Yes/No If YES, please provide the name of the organization, its address, and charitable registration number 9. Is the project a collaboration between two or more past ROI participants? Yes/ No If YES, who are they and what is their role in the project? 10. Please describe the project for which you are seeking funding? Please describe the your motivation for creating, how it will work, and what its goals are (250 words, maximum). I want to create an online project to allow individuals from the world to give small grants to projects being undertaken by Israeli teens who are connected to the Israel Association of Community Centers (matnassim). The goal is create connections between Diaspora Jews, Israelis, and others with strong relations to Israel and its diverse population to make real investment with pointed impact. The IACC reaches vastly different populations, Jews, Arabs and Christian, native-born Israelis and immigrants, from diverse socio-economic backgrounds, and different lifestyles. With small sums that will add up to grants of $500$1000 to teenagers to run communally-based projects, Global Jewish Grants will allow linkages to be formed with little overhead. Small grants by individuals be made to an international non-profit organization. Online they will see projects that teens are interested in running and will flag their donation for that philanthropic investment. They will then network this to the Facebook friends through a specially designed Facebook application. When a project has hit the amount of commitments it needs, the funds will be released to the teen. The Israeli teen will post progress reports to the Facebook Group around his/her project and real time visits will be possible when donors come to Israel. The coordination of this end will come from the IACC. ROI Grants: Sample Application Form Page 2/2 11. How much money are you requesting? Describe in detail how the funds you are requesting will be used. I am requesting a grant of $5,000 which will be used as follows: 1. Facebook Application Development $1,500 2. Grant to IACC for Workshop for Teens in Project Development $2,000 3Staff person for writing materials, networking with host NGO $1,500 I will coordinate this project myself. However I will need some junior staff time to write materials, utilize Facebook and other apps, work on the technical relationship with the organization who will host the grant gathering, and provide general administrative support. 12. Please describe how you will determine if the project is a success and how you intend to evaluate its success? When you expect this evaluation to occur? The project will be a success if we: 1. Collaborate well with the IACC and produce a group of teens with ideas that need funding. 2. Manage the design and creation of the Facebook application successfully. 3. Get at least 100 people to make grants through the Facebook application. 4. Deliver these funds to projects and document their progress. 5. Successfully publicize the work. 13. Please provide a full project budget. Please note what percentage of the full budget you are seeking to have covered by the ROI Grants Pool and what other sources of funding you are seeking or have received. 1. Facebook Application Development $1,500 2. IACC for Workshop for Teens in Project Development $5,000 3. Staff person for writing materials, networking with host NGO$1,500 4. Staff time at international host organization (equivalent) $10,000 $18,000 I am requesting that ROI fund 28% of this project, if you include in-kind. Beyond the funds I am requesting from the ROI Small grants pool, the rest will be provided by the organizations I will be working with as cash or in-kind gifts. 14. Please provide contact information for two references (name, phone, and email address) who work or have worked with you and are familiar with your project. 1. David Cohen +972.3.9871234; david@cohen.org 2. Ayelet Levi +972.3.56709876; ayelet@levi.com

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