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) Organization. *City Instructions: *State Instructions: (Single-Select List) *Zip Instructions: *County (Single-Select List) Adams - IL Brown - IL Cass - IL Christian - IL Green - IL Hancock - IL Instructions: 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) organization. *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 Instructions: 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? (Yes/No) 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. Request Instructions: *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 (Date) completed. *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) Instructions: Conference Please select the value which best describes the Consultant format of this grant. Institute for Excellence in Leadership Certificate Program Materials Technology Workshops Other *Project Goals Instructions: What are you trying to achieve as a result of this (Paragraph; 2000 character maximum) grant? *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. Instructions: 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. Instructions: 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 Instructions: *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 agency. Instructions: 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. Need Support?
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