Request for Proposals
2010 Grant Applications Deadline: July 24, 2009 by 5:00 p.m.
Contact Information Wendy Noe 1099 N. Meridian Street Suite 111 Indianapolis, IN 46204 317-638-2873 (ph) 317-634-4980 (fax) wendy_noe@komenindy.org
Message about the Indianapolis Affiliate of Susan G. Komen for the Cure
Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything in her power to end breast cancer forever. In 1982, that promise was to become Susan G. Komen for the Cure (SGKC) and launched a global breast cancer movement. Today, SGKC is the world’s largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure, we have invested over 1.2 billion in fulfilling our promise by becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world. The Indianapolis Affiliate of SGKC—along with those who generously support us with their talent, time and resources—is working to better the lives of those facing breast cancer in our community. We join hundreds of thousands of breast cancer survivors and activists around the globe as part of the world’s largest and most progressive grassroots network fighting breast cancer. Through events like the Komen Indianapolis Race for the Cure, we have invested in local breast health and breast cancer awareness projects in Marion, Bartholomew, Boone, Brown, Clinton, Decatur, Delaware, Grant, Hamilton, Hancock, Hendricks, Henry, Howard, Johnson, Madison, Montgomery, Rush, Shelby, Tippecanoe, Tipton and Morgan counties. Up to 75 percent of all funds generated by the Komen Indianapolis Affiliate stay in the 21 county Affiliate Service area, while the remaining income goes to the National SGKC Award and Research Grant Program. This national grant program supports scientific research programs around the world. The Indianapolis Affiliate of Susan G. Komen for the Cure, Inc. is currently offering grants for innovative projects in the areas of breast health and breast cancer education, outreach, screening, and treatment support, targeting services not otherwise available to the medically underserved populations of Indianapolis Affiliate area counties. Grant awards cover one calendar year.
Guidelines:
Applications will be accepted for breast health or breast cancer screening, treatment, education, or treatment support projects in the 21 county service area of the Komen Indianapolis Affiliate. However, projects that specifically address the objectives outlined in the “Statement of Need” below will be given priority. All requests for scientific research funding should be directed to Komen’s Award and Research Grant Program. More medical research funding information is available at www.komen.org/grants.
Statement of Need: The Indianapolis Affiliate of SGKC has identified the following needs by surveying our local breast cancer community; (please visit www.komenindy.org for a complete listing) Provide and encourage provider education for all specialty and primary care providers. Increase access to care among rural women and the working poor who may fall slightly above 200% of poverty Ensure all women, including rural, have access to clinical breast exams, and mammograms that follow the screening guidelines. Provide community education programming focusing on African American women, rural women, pre-menopausal women and Latina women. Ongoing Partnership & Support Services for breast cancer survivors.
“Access” is not defined solely by a patient’s medical insurance coverage; access may also include translators/bilingual services, child-care services, transportation, etc.
The purpose of this program is to address the breast health and breast cancer screening, treatment, and education needs of the Indianapolis Affiliate Service Area.
Qualifications: Applications are accepted from nonprofit organizations and must be
submitted in English. Applicants must mail one original copy, as well as submit the application electronically via email.
Restrictions: Project must be specific to breast health and/or breast cancer; e.g. if a project is a combined breast and cervical cancer project, funding may only be requested for the breast cancer portion.
Applicants must be a US nonprofit (federally tax-exempt) organization, e.g. nonprofit organizations, educational institutions, government agencies and Indian tribes are eligible. Services must be provided within the Indianapolis Affiliate Service Area: Services and activities can only be provided within the following counties: Bartholomew, Boone, Brown, Clinton, Decatur, Delaware, Grant, Hamilton, Hancock, Hendricks, Henry, Howard, Johnson, Madison, Marion, Montgomery, Morgan, Rush, Shelby, Tippecanoe and Tipton.
Indirect costs are strongly discouraged. If requested, indirect costs must be clearly documented and justified and not exceed 10% of the total budget.
Equipment costs, if applicable, may not exceed 30% of direct costs and should be used exclusively for the proposed project. Salaries, if requested, are for personnel related to this project only and not the general work of employee.
Review: Completed applications that meet guideline compliance, will be submitted for full review by a panel established through the local grants committee. Education Materials: A variety of educational materials are available from SGKC. Some items are targeted to special populations. Before requesting funds to purchase items from other sources, or create new materials, please contact the Indianapolis Affiliate of Susan G. Komen for the Cure. We recommend that Komen materials be used in the project whenever possible. Contracts: A grant contract will be sent to all successful grant recipients. Grant period: Grant period begins January 1, 2010 and will conclude on December 31, 2010. Payment and Reporting: The first payment will be made no later than thirty (30) days after receipt of the fully executed contract. The first progress report is due at the end of the first six (6) months of the calendar year. A final report is due within forty-five (45) days of the end of the grant period. Letters of support and additional materials: Letters of support from collaborating groups or organizations will strengthen a proposal and are strongly encouraged. However, DO NOT send additional materials (i.e. reprints, complete curriculum vitae) as they will not be reviewed. Confirmation of receipt of application: Confirmation of receipt of application will be emailed to the project director following review for guideline compliance. If immediate confirmation of receipt is requested, please include a self-addressed, stamped postcard that will be returned to you immediately upon receipt of the application. Please do not contact the Indianapolis Affiliate regarding the status of the application during the review period. Announcement: Announcement of grants awarded will be made by November 5, 2009.
Important Dates:
Electronic/Hard Copy Due Date July 24th, , 2009 5:00 p.m.
Late or incomplete proposals will not be accepted.
Notification of Decision
Applicant will be notified via email and regular mail. The grant award letter will outline the grant period, payment schedule and reporting deadlines.
November 2, 2009
Project Start & End Dates First of two payments Second Payment & Progress Report Due Final Report Due
January 1, 2010 December 31, 2010 December 9, 2009
First of two payments after receipt of signed Grant Contract
July 9, 2010 February 11, 2011
Note: The Indianapolis Affiliate of Susan G. Komen for the Cure reserves the right to alter the project dates as necessary. Applications should include 1 inch margins and be ordered as follows: 1. Cover Page (Form attached) Note: Signature of approving institutional personnel, other than project director, required.
2. Organizational Background (Do not exceed one ½ page) a. Identify the Target population for this project b. Show how your target population addresses Komen’s Community Profile (see page… or online at www.komenindy.org) c. Outline your organizations experience developing and implementing programs for these target population(s) 3. Project Description (Do not exceed two typewritten pages. Font size should be no smaller than a twelve-point typeface.) a. Provide a concise explanation of the proposed project. b. What are your primary goals? c. What is your plan for achieving those goals? d. How will you recruit participants for your project? e. How will you ensure that this program is culturally sensitive? f. What potential challenges do you foresee-and how will you address them? 4. Resources (Do not exceed one page) a. Provide a statement that clearly shows the resources your organization has for this project. Please refer to the following: partnerships (schools,
churches, business, medical centers, etc.) facilities and equipment (computers, etc.) b. Identify the staff that will implement this program/project; briefly describe each person’s education, experience and expertise. c. Include your organizations plans for sustaining this program/project in the time following Susan G. Komen funding. 5. Timeline (Do not exceed one ½ page) a. Provide a realistic timeline for implementing your proposed project divided into quarters. Begin your timeline on January 1st, 2010 and end it on December 31st, 2010 6. Evaluation Methods (Do not exceed one ½ page) a. Based on goals, describe measureable objectives and how you will collect dat. How will you know that you are making progress toward your proposed outcomes? 7. Financial Information (Not to exceed two typewritten pages). a. Budget for requested funds (Form attached). b. Budget justification. i. Education: Total Budget; Total people served; Cost per person served ii. Screening: Total Budget; Total people served; Cost per person served iii. Navigation: Total Budget; Total people served; Cost per person served iv. Treatment: Total Budget; Total people served; Cost per person served v. Support Services: Total Budget; Total people served; Cost per person served c. List of other sources of current funding for the project. Applications must be submitted by the director of the project. Keep grant requests to the page limits, as stated above. Excess pages will be removed prior to review. Email one copy and mail 1 original, of the application. Applications should be bound by staple, clips only. Please no spiral bound materials. Faxed copies will not be accepted. Failure to adhere to these guidelines will result in delayed processing or refusal of funding. Applications must be postmarked by July 24, 2009 Indianapolis Affiliate Susan G. Komen for the Cure Attn: Wendy Noe 1099 N. Meridian Street #111 Indianapolis, IN 46204 wendy_noe@komenindy.org Inquiries should be addressed as above or directed to 317-638-2873
Thank you for your interest and support in joining us in the fight against breast cancer!
Grant Writing Resources
Basic Guide to Program Evaluation -http://www.managementhelp.org/evaluatn/fnl_eval.htm#anchor1587540 CDC’s SMART Objectives -- http://www.cdc.gov/HealthyYouth/evaluation/pdf/SMARTcards.pdf Writing SMART Goals and Objectives Presentation Handouts -http://commpartners.com/eoplugin/naccho/080424/Presentation%20Handouts.pdf Exercises in writing SMART Goals and Objectives http://commpartners.com/eoplugin/naccho/080424/NACCHO%20GO%20exercises.pdf Answers to exercises in writing SMART Goals and Objectives http://commpartners.com/eoplugin/naccho/080424/NACCHO%20GO%20exercises%20-%20Answers.pdf Grant Proposal Writing Tips -http://www.cpb.org/grants/grantwriting.html
Technical Assistance; Komen Indy Program staff will be available during the course of the grant
period to provide technical assistance to funded projects. Technical assistance may include, but is not limited to: o Giving guidance regarding evaluation measures and data collection. o Helping projects to identify and resolve challenges. o Providing information or sharing educational resources for cancer prevention. o Providing general ideas or suggestions for implementing the proposed project. o Pre-Review of proposal Assistance may be provided through three means: o Telephone technical assistance (one-on-one and conferencing); Written correspondence; Onsite technical assistance
COVER PAGE
Request for Funding
PROJECT DIRECTOR & TITLE INSTITUTE ADDRESS
PHONE FAX EMAIL TITLE OF PROJECT TOTAL AMOUNT REQUESTED GRANT PERIOD SIGNATURE & TITLE OF APPROVING PERSONNEL (OTHER THAN PROGRAM DIRECTOR) NAME & TITLE OF APPROVING INSTITUTIONAL PERSONNEL (TYPED)
( (
) )
January 1, 2010-December 31, 2010
DATE
PLEASE CHECK TYPE OF APPLICATION:
EDUCATION SCREENING TREATMENT PATIENT NAVIGATION SUPPORT SERVICES
Applications Must Be Postmarked By July 24, 2009 (Photocopies of this form are acceptable)
ABSTRACT PAGE
PROJECT DIRECTOR ORGANIZATION/INSTITUTION BCCCP PROVIDER? TARGET POPULATION YES NO
Abstract
In the space below, please provide a short abstract, not to exceed 200 words, written in lay terms for release to the general public should this application be chosen for funding.
Permission to publish: Permission is hereby granted to Susan G. Komen for the Cure, Inc. to publish the above abstract should this application be selected for funding.
SIGNATURE DATE NAME (TYPED) PHONE NUMBER
FINANCIAL INFORMATION
BUDGET JUSTIFICATION OUTLINE In an outline format, please provide the justification for your budget proposal. Please limit to two pages. A. PERSONNEL INTEGRAL TO THE PROGRAM 1. Salary: For each person listed, describe the duration of the position, the percentage of time to be spent on the program, the salary per month and the total requested salary amount. Attach a job description. 2. Benefits and Payroll Taxes: Describe the basis for these line items. B. MATERIALS AND SERVICES INTEGRAL TO THE PROGRAM 1. PROGRAM MATERIALS: a. Educational materials: Include cost and quantity estimates. (Please use Komen breast health educational materials as your first resource.) b. Food: describe quantities, price and occasion(s). c. Postage/Shipping: describe what will be shipped, how often, and for what purpose. d. Advertising and promotion: describe your plans to promote or advertise the project, what methods will be used and at what expense, frequency, to reach whom? 2. Travel and Transportation: a. Staff: describe basis for estimates (Justify reason for out of state travel, if any). b. Client transportation: describe need and basis for expense. C. INDIRECT COST ALLOCATION (NOTE: Indirect costs are strongly discouraged and cannot exceed 10% of total budget. If requested, please document and justify these costs and their relationship to the program outcome.) 1. Facility Expenses: a. Space rental: How much space, at what rate, for what purpose and over what period of time. b. Utilities: Describe what utilities are included, over what period of time, and at what rate. c. Phone: Include long distance and local service and explain basis of estimate. 2. Other Program Expenses: a. Computer software: What software will be needed and for what purpose. b. Other: List each item and explain the basis for your estimate and the purpose of the item, relative to the program’s projected outcome.
BUDGET FORM
TYPE OF EXPENSE AMOUNT REQUESTED A. Personnel Expenses: 1. Salary 2. Benefits and/or Payroll Taxes B. MATERIALS & SERVICES 1. Program supplies a. Educational supplies b. Food c. Postage/shipping d. Advertising/ Promotion e. Screening Costs 2. Travel/Transportation a. Staff b. Clients 3. Facility Expense a. Space rental b. Utilities c. Phone 4. Other Expenses a. Software b. Other C. INDIRECT COSTS (IF ANY) (INDIRECT COSTS ARE STRONGLY
DISCOURAGED AND MUST BE LESS THAN 10% OF TOTAL BUDGET)
OTHER FUNDS AVAILABLE
IN-KIND MATCH
TOTAL COST
TOTAL EXPENSES D.
OTHER SOURCE/S OF FUNDING FOR THIS PROGRAM: Please list other sources of funding for this request and the status of the other funding.
SOURCE AMOUNT PENDING/COMMITTED