Sample Capacity Grant Completed by nqd16111


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									                        Sample – Capacity Building Grant Application
This is an example of the application questions with which you will be presented. It is recommended that
you compose the answers to the paragraph questions in a word processing program and then cut and paste
that text into the online application.

                                  Organization Information

*Organization/School Legal Name                      Instructions:
(Text; 100 character maximum)                         Please enter the Legal Name of your Organization.

*Address                                             Instructions:
                                                      Please enter the Address for the Main office of this
(Text; 100 character maximum)

*City                                                Instructions:

*State                                               Instructions:
(Single-Select List)                                 

*Zip                                                 Instructions:

(Single-Select List)
 Adams - IL
 Brown - IL
 Cass - IL
 Christian - IL
 Green - IL
 Hancock - IL
 Jersey - IL
                                                      Please select the county where your organization
 Lewis - MO
                                                     is headquartered.
 Marion - MO
 McDounough - IL
 Morgan - IL
 Pike - IL
 Sangamon - IL
 Scott - IL
 Schuyler - IL
 Other County - Anywhere USA

*Telephone                                           Instructions:
                                                      Enter the phone number for the Main Office of this
(Text; 30 character maximum)

*E-mail Address                                      Instructions:
                                                      Enter a main e-mail address for your organization
(Text; 100 character maximum)
                                                     (use your own if there is not a generic inbox).

Fax                                                  Instructions:
(Text; 30 character maximum)                         

*Type of Agency
(Single-Select List)
 Church
 Other
                                                      Please select one from the list provided.
 School
 Traditional Charity
 Unit of Government

*Name of Executive                                   Instructions:
Director/President/Principal                          Please enter the name of the Executive
(Text; 255 character maximum)                        Director/President of this Organization.
*Have you ever received funding
from a Tracy Family Foundation               Instructions:
grant?                                       

Purpose of previous Tracy Family             Instructions:
                                              If you have received a grant from the Tracy
Foundation grant                             Family Foundation in the past, please briefly
(Paragraph; 2000 character maximum)          describe the purpose of that grant.

Amount of Previous Grants                    Instructions:
                                              Please note grants received from Tracy Family
(Paragraph; 2000 character maximum)
                                             Foundation within the past 3 years.

*Organization Mission Statement              Instructions:
                                              What is the basic purpose of your organization:
(Paragraph; 1000 character maximum)
                                             one brief paragraph (Max. Char. 1000).

*Year Founded (YYYY)                         Instructions:
(Number; 15 digit maximum)                    Year your organization was established

*Purpose of the Organization                 Instructions:
(Paragraph; 2000 character maximum)          

*Programs Offered                            Instructions:
(Paragraph; 2000 character maximum)           Please list the programs your organization offers.

*Target Population Served by Agency          Instructions:
                                              What population does your organization serve?
(Paragraph; 2000 character maximum)
                                             e.g. "at-risk youth"

*Organization Locations                      Instructions:
                                              If your organization has other locations or offices,
(Paragraph; 2000 character maximum)
                                             please list them here.

                             Organization Contact Information

    1. If this is your first time applying online, please fill out all the fields below.
    2. If you are returning to the site, verify contact information by either clicking on
       "Contact Name" to edit, or if there are no changes, checking the box next to
       "Match" to select.
    3. If contact information is not listed, click on "Create New" and fill in the
       appropriate Contact information.

*Contact First Name                          Instructions:
(Text; 40 character maximum)                  This should be the organization's contact name.

*Contact Last Name                           Instructions:
(Text; 40 character maximum)                  This should be the organization's contact name.

*Contact Title                               Instructions:

*Contact Address                             Instructions:
                                              Please enter your address (may be different from
(Text; 100 character maximum)
                                             your organization's primary location).

*Contact City                                Instructions:
(Text; 50 character maximum)                 

*Contact State                               Instructions:
(Single-Select List)                                   

*Contact Zip                                           Instructions:
(Text; 20 character maximum)                           

*Contact Telephone                                     Instructions:
(Text; 30 character maximum)                           

*Contact E-mail Address                                Instructions:
(Text; 100 character maximum)                           Please use your own e-mail address.


*Project Title                                          Please give a name to the grant you are
(Text; 255 character maximum)                          registering. Use 'General Operating Support' if a
                                                       project does not apply.

*Request Amount                                        Instructions:
(Currency; 20 character maximum)                        The recommended maximum request is $2000.

*Dollar Amount of Agency                               Instructions:
Contribution                                            An agency must contribute a minimum of 25%
(Currency; 20 character maximum)                       (cash- not In-Kind) of the TFF request.

*Executive Director/Pres./Principal                    Instructions:
Authorization                                           Has your Exec.Director/President/Principal
(Yes/No)                                               authorized this request?

*Request Summary                                       Instructions:
(Paragraph; 2000 character maximum)                     Please summarize your request.

*Importance of Proposed Project                        Instructions:
(Paragraph; 2000 character maximum)                     Outline evidence for the need of this grant.

*Project Start Date                                    Instructions:
(Date)                                                  Please enter the date your project will begin.

*Project End Date                                      Instructions:
                                                        Please enter the date when your project will be

*Focus of Capacity Building Grant
(Single-Select List)
 Agency-Specific Training
 Board Development/Governance
 Collaboration
 Financial Management/Budgeting                       Instructions:
 Fund Raising                                          Please select the focus that best defines the area
 Human Resource Management                            within your agency that is being targeted for
 Management/Leadership                                capacity building with this grant.
 Marketing/Communications
 Program Development/Evaluation
 Strategic Planning
 Technology Development
 Other

*Grant Funds will be used for:
(Single-Select List)
 Conference
                                                        Please select the value which best describes the
 Consultant
                                                       format of this grant.
 Institute for Excellence in Leadership Certificate
   Materials
   Technology
   Workshops
   Other

*Project Goals                              Instructions:
                                             What are you trying to achieve as a result of this
(Paragraph; 2000 character maximum)

*Project Strategies                         Instructions:
                                             A strategy is a detailed description of the activities
(Paragraph; 2000 character maximum)
                                            that will take place.

*Project Outcome(s)                         Instructions:
                                             What change or outcome are you expecting as a
(Paragraph; 2000 character maximum)
                                            result of this grant?

*How will you measure the success           Instructions:
                                             Please list 3 indicators that you will measure. For
of this project?                            example...Increased number of clients, increased
(Paragraph; 2000 character maximum)         board giving, increased earned income, etc.

                                             Please outline timelines as they relate to Project
                                            Strategies. Please click here for the TIMELINE
*Timeline Template
                                            TEMPLATE. Open the template, type in your info and
(File Upload; 1,048,576 byte limit)
                                            save in your computer files. Then click "Upload File"
                                            and select document. You can only upload files that
                                            are done in Microsoft Word, Excel and PowerPoint.

                                             Please click here for the BUDGET TEMPLATE. Open
                                            the template, type in your info and save in your
*Project Budget Template                    computer files. Then click "Upload File" and select
(File Upload; 1,572,864 byte limit)         document. (See Instructions in beginning of this
                                            section regarding Uploading Files). You can only
                                            upload files that are done in Microsoft Word, Excel
                                            and PowerPoint.

                                      Current Year

*Key Staff Member Information                List key staff members relevant to this request.
(Paragraph; 2000 character maximum)         Include their qualifications and length of time at this

                                             Please click here to review our Letter of
                                            Agreement. If you accept these terms, select I
*Letter of Agreement - Review and           ACCEPT. Please note: Your organization may be
                                            subject to additional terms of agreement and these
Accept Terms                                terms, if necessary, would come to you via email.
(Checkbox List)                             Accepting this letter does not mean that you
 I ACCEPT                                  have been approved for a grant, however you
                                            must accept in order to proceed. You will be
                                            notified via email whether or not your grant
                                            request has been approved.

*Name of Individual Agreeing to             Instructions:
Terms                                        Please type your name here to acknowledge you
(Text; 255 character maximum)               have read the Letter of Agreement.

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