'Foundation Proposal Statement of Work'

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					Effective April 2009, the Foundation eliminated the IRS Determination Letter and the
Annual Report or Statement of Activities as required attachments. To verify tax
exempt status, the Foundation will rely on Guidestar Charity Check to access
Publication 78 and the IRS Business Master File. Tax papers may be requested only if
information from these online resources is insufficient.

To help us enter your organization's data correctly in our database, we ask that this
cover sheet contain all of the information requested, in the order that it appears. If an
item does not apply, answer "none" or "n/a." Do not delete the item or leave it blank. If
items are missing, it may delay the processing of your proposal.

A. General Information about your Organization.
Federal Tax ID #
Legal Name
Division/Department Name
Mailing address
City/State/Zip code
Phone #
Fax #
General email address
Mission Statement
Total Revenue & Support (income from all sources for the most recently completed
Fiscal Year End Date:

B. Contact Information
Provide full contact information for each of the following individuals of your

                   Primary Contact          Leader of Organization           Board Chair
                  Person for Project
FAX Number

C. Key Information About Your Proposal
One sentence summary of the purpose for which funds are being requested
Total cost for work proposed
Total amount requested from WPF
Duration of requested funding period
Complete all items below. While there are no page limits, it is important to be clear and

(A) Organizational Background (answer for the organization as a whole)
     Provide a brief historical background, including accomplishments that relate to
       the proposed project and the organization’s current strategic plan.
     List the organization’s goals
     Describe existing programs and services and how they relate to the
       organization’s mission and strategic plan
     Define the geographic area served
     Describe the constituency served (age, gender, race/ethnicity, income level)

(B) Executive Summary of the Entire Project
        Provide a short (one page maximum) summary of the context, description,
           and outputs and outcomes for the project for which you are requesting

(C) Context of the Proposed Work (answer for the specific proposal)
        Define and document the need for the proposed work and how it relates to
           your organization’s mission and strategic plan. Include relevant data if
           available and applicable.
        Discuss how the proposed work relates to the field. If applicable, mention
           any proposed collaborations and, if possible, cite research supporting the
           effectiveness of your proposed strategy and any best practices used in your
           program development
        Define as specifically as possible the geographic location of the primary
           constituency served by the proposed work, if different from organizational
           background description. For example, a project might cover as broad and
           area as our entire grantmaking region or be as specific as serving residents in
           a single municipality, neighborhood, or zip code
        Describe the primary constituency(ies) that will benefit from the proposed
           work (age, gender, race/ethnicity, and income level), if different from
           organizational background description.

(D) Description of the Entire Project
       Describe the proposed activities to be performed to achieve the anticipated
          outputs and outcomes. If you expect to expand or replicate an existing
          program, include evidence of that program’s effectiveness (reports,
          evaluations, articles, etc.)
       Timetable of key project benchmarks

(E) Anticipated Outcomes of the Grant
    Outputs are the major products and/or the substantial and completed processes that
    are created to reach outcomes. They occur “in order to achieve” an intended
    outcome. Outcomes are the desired change(s) or results that the proposed project
    will eventually accomplish. They follow from the outputs and identify the anticipated
    change that is the goal of the grant. Please use the Outputs and Outcomes
    worksheet to complete this section.
      Indicate the strategic relevance—the Foundation priority and objective or
       strategy--that your work addresses or advances
      Describe the expected outputs for this proposal. What short-term
       accomplishments, products, or other outputs do you expect to achieve in each
       part of your work during the grant period? By when?
      Indicate the anticipated grant period outcomes or results. What outcomes or
       changes do you expect to see and be able to measure in each part of your
       proposed work by the end of the grant period? Include a timetable for achieving
       outcomes if requesting multi-year funding.
      Indicate anticipated post-grant outcomes—those you expect to see two-to-three
       years after the grant period.

   Note: Outputs and outcomes should specify measures that will show the evidence
   or progress of key project benchmarks.

(F) A breakdown of funds requested from the Foundation. Include total amount,
    duration (over x months) and specific purpose (ie: consulting, evaluation,
    publications, etc.)

(G) List the names of all other sources of funding specific to the project. Include the
    organization name, total amount, and duration of the funding:
               (a) funds already committed;
               (b) funds for which you have applied and a commitment is pending;
               (c) funds for which you will apply

(H) Plans for continued support at the conclusion of the requested grant, if relevant.
These documents must be attached to your completed proposal. In each case the
documents should be from the applicant organization (the organization that will receive
and administer the funds).

1. Most Recent Financial Statement – The Foundation follows the guidelines below for
   financial statements. If the statements are not yet complete for the most recently
   completed fiscal year, the organization should provide a draft or end-of-year

Organization Type                        Financial                  Type                      990
                                       Statements                                           Required
Nonprofits                                  Yes      Follow State Requirements (see            Yes
Government and Quasi-Public Agencies      Yes        Government Audit or Financial Report      No
Universities and Hospitals                Yes        Annual Report with Audit Information      No
New/Start Up Organizations                Yes        Current Operating Budget and 990          Yes
                                                     Schedule A                             Schedule A

Pennsylvania State Requirements
In order to solicit funds in Pennsylvania, all organizations are required to submit
financial statements according to the following chart: reviews and compilations provide
considerably less testing and verification than full audits.

                           Bureau of Charitable Organizations
  (refers to contributed, not earned, income)
Greater than $25,000 but less than $50,000       Either Internal Statement, Compilation,
                                                 Review, or Full Audit
Greater than or equal to $50,000 but less than Either Compilation, Review, or Full
$100,000                                         Audit
Greater than or equal to $100,000 but less       Either Review or Full Audit
than $300,000
Greater than or equal to $300,000                Full Audit

    2. Operating Budget for the Current Fiscal Year -- For multi-year projects a full
       operating budget for each year of the request should be included.
        For universities, the operating budget should reflect the department or
          school being funded, not the budget for the entire University.

    3. Total Project Budget -- The budget should include a list of the detailed costs for
        the total project and costs to be covered by the proposed request. The budget
        should list all direct costs including those related to measuring anticipated
        outcomes. For multi-year projects, a full budget for each year that funds are
        being requested should also be included. A budget template is available on the
        Foundation's website for requests from Children, Youth and Families and
        Environment and Communities applicants.
4. Consultant Information -- If funds are being requested from the Foundation for
   a consultant, the proposal should indicate: (1) full contact information of the
   consultant, if available at time of application; (2) total costs per consultant or
   contract; and (3) consultant's scope of work to be performed. Up to four client
   references and a detailed description of the qualifications to carry out the
   proposed work should also be attached.

5. IRS Form 990, including Schedule A (for nonprofits and new/startup
   organizations only) – If the 990 for the most recent fiscal year is posted on the
   GuideStar web site (www.guidestar.org), then the organization does not have to
   include it. Foundation Grants Management staff will download the current
   version and attach it to the pending request record in GIFTS.

6. Current List of Officers and Board Directors – Include full name, title, and
   organization affiliation.

7. Profiles of Key Organization Leaders and Staff

8. Amended Articles of Incorporation – required only if an organization recently
   changed its legal name

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