Tax Form 1165 by kpc11388


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									                                           THE LONGLEAF FUND
                                    Grant Application Overview: 2011 Grant Cycle

The Longleaf Fund invests in the academic success of public school students within the following communities it
serves: Charlotte, NC; Raleigh, NC; Columbia, SC; Greenville, SC; and Spartanburg, SC. The Fund accepts grant
applications from nonprofit organizations in two (2) areas of focus:

FUNDING AREA 1: K-9 Public Education Support Services (emphasizing 5th – 9th grades)
The Longleaf Fund supports students in public elementary and middle schools. The Fund sees this time as critical
to predicting student academic achievement and high school graduation. The Committee seeks programs focusing
on the following results:
     Underachieving students achieve at or above grade level, with an emphasis on elementary school literacy
     Children & youth exhibit positive behaviors during out-of-school hours through accessible, high quality
        after-school, summer and extended day learning opportunities
     Students transitioning from 5th to 6th and from 8th to 9th grades have access to and are provided the
        necessary support services to decrease the likelihood or occurrence of dropout indicators
   For applications within this area, the Fund awards grants up to $150,000, payable in multi-year payments, as
   determined by the Committee. Grant requests should be structured accordingly; keeping in mind that partial
   funding may be awarded.
   If awarded, FFTC staff will determine the schedule for submitting evaluation report(s) on grant outcomes and
   grant expenses, depending on the award. Based on our annual reporting calendar with clients and volunteers,
   the first report is due approximately 9 months after the initial grant award date. Reallocation of funds or
   extensions beyond terms awarded requires a written request to be approved by the Advisory Committee.

FUNDING AREA 2: Out-of-School Time for Special Needs Students (ages 0-18)
The Longleaf Fund also supports programs serving students, ages of 0-18, with special needs (both physical and
mental disabilities) during out-of-school time.

   For applications within this area, the Fund awards one-year grants up to $50,000. There is a 3-year waiting
   period between grants within this funding area.
   Based on our annual reporting calendar with clients and volunteers, the first report is due approximately 9
   months after the initial grant award date. Reallocation of funds or extensions beyond terms awarded requires a
   written request to be approved by the Advisory Committee.

   Basic operating support; endowment funds
   Direct support of individuals; scholarships to private or parochial schools
   Travel and conferences; publication of books
   Projects that promote political or religious views
    Grants are limited to eligible organizations for projects in or benefiting Charlotte, Columbia, Greenville,
      Raleigh and Spartanburg
    Eligible organizations include 501(c)(3) nonprofit organizations, congregations, governmental and
      educational institutions. See the Grant Application Checklist for more information.

2011 Grant Application (Longleaf)
                                                  THE LONGLEAF FUND
The deadline for this grant application is Friday, March 4, 2011. A hard copy original of the application is required
and must be received by the grant application deadline. Applications received after the deadline will not be
accepted (postmarked applications for the due date will be considered late). Applications should be addressed to:
         The Longleaf Fund
         c/o Foundation For The Carolinas
         Attn: Catherine Warfield                                          Phone: (704) 973-4515
         217 South Tryon Street                                            Fax: (704) 973-4915
         Charlotte, NC 28202                                               Email:
To conduct a fair and ethical grants program, the Foundation follows a conflict of interest policy, which states that volunteers and/or staff not
participate in the grant process for an organization with which they are affiliated. If an individual or organization wishes to express support
for your project’s application, please have them contact the Client Services department at the Foundation.

2011 Grant Application (Longleaf)
                                            THE LONGLEAF FUND
                                Grant Application Checklist: 2011 Grant Cycle
    You must follow these guidelines to submit a completed package:
      1. Assemble the items in your grant application in the order listed below. Do not place your proposal and
            application in a special binder or notebook. Applications are disassembled and copied during processing.
       2. Check off each item when completed.
       3. Submit this checklist as the first page of your application package.
    Please note: This application is provided in Microsoft Word form and is locked for editing. If you
    experience any challenges completing this application, please contact Catherine Warfield.

        1. Name of Organization
        2. Complete the Grant Proposal Summary.
        3. Have the Grant Proposal Summary signed by the Executive Director.
        4. Complete the Grant Project Description.
        5. Complete the Project Budget Form indicating sources of income and expenses.
           Indicate the specific purpose(s) for which the grant funds will be used.
        6. Attach Core Components of your Audited Financials, including statements of financial
            position, activities, functional expenses and cash flow. Do not include your entire audit and do
            not include any bound copies.
        7. Attach Annual Operating Budgets for previous & current years (revenues & expenses)
        8. Send a list of the current Board of Directors of your organization.
        9. Send proof of eligibility as one of the entities below:
            1. 501(c)(3) organizations: Attach a copy of your organization’s official notice of tax exempt status from
               the IRS.
            2. Local unit of national organization: Certification of membership or group exemption letter (Note,
               national or parent organization must be an FFTC approved organization, per below)
            3. Religious organizations: Staff/Board list, recent bulletin, proof of affiliation with larger
            4. Public Schools: Staff list of school and name of participating school district
            5. Government organizations: Proof of governmental affiliation (written verification from state or local
               municipality of department/agency affiliation)
         10. Send Form 990 if not on FFTC’s list of approved organizations as outlined below:
     *In order to be considered for a grant, the applicant organization must be approved through Foundation For The
     Carolinas’ due diligence process. If you are not currently approved to receive grants from FFTC, please submit a
     990 in addition to the requirements included in the application checklist. If you would like to confirm if your
     organization is already approved, please visit the list of approved organizations, at > Donors >
     Donor Resources > Approved Organizations.

     If your organization is applying under a fiscal agent, please contact Catherine Warfield for additional
     requirements before completing this application.

2011 Grant Application (Longleaf)
                                             THE LONGLEAF FUND
                                          2011 Grant Proposal Summary
Applicant Organization                            Date of Incorporation

Address                                           Annual Operating Budget

City         State          Zip                   Current assets of organization

Name of Contact                                   Date of last audit

Title                                             Email

Telephone                                         Amount of Grant Request

Grant Project Name

Application Funding Area (select one)                 Area 1 (Education)       Area 2 (Special Needs)

Grant Summary
Please provide a brief 2-3 line description of the project/ program and specifically, the expected end result(s) to be achieved
by grant funding. Additionally, please note that if awarded funding by the Longleaf Fund, the grant summary provided within
this application will be used in FFTC’s Annual Report. (Maximum length of 500 characters)

Example: Requested funds will be used to support our after school program, which targets at-risk youth during out-of-school
time. Specifically, grant funds will provide a safe environment for 25 at-risk youth ages 12-15, to encourage positive behaviors
and improve academic performance.

Do you need any licensing, zoning or other regulatory approval to conduct this project?      Yes      No
If yes, explain status on an attachment.

Approval of Executive Director and Board of Directors:
We approve submission of this grant request. We certify that the applicant organization does not discriminate on the basis of
race, color, age, sex or national origin. We also certify that our most recent IRS notification of our organization’s 501(c)(3)
status is attached to this application and that the organization has received no notice from the IRS of any proposal, threat or
suggestion to revoke or modify this determination. For all grant requests of $25,000 or higher, the grant application must also
be signed by an officer of the Board of Directors. For all grant requests less than $25,000, a Board officer signature is

Executive Director Signature/Date
Executive Director Name (Print)

Board Officer Signature/Date
Board Officer Name (Print) and Position

2011 Grant Application (Longleaf)
                                         THE LONGLEAF FUND

                                      2011 Grant Proposal Summary
Please answer the questions below as concisely as possible. Answers must be typed (no handwritten
applications accepted).

   A. What is your organization’s mission? If you have any principles or values that are actively used in your programs
      and management, please include them. (Maximum length of 650 characters)

   B. Please briefly describe the project and name the three to four critical steps for the successful completion of your
      results. (Maximum length of 1000 characters)

                                       2011 Grant Project Description
The Project Description should not exceed three pages.

   1. What problem are you addressing, in what service area (geographic area, etc.) and about how many individuals
      within the service area have the problem?

   2. Describe your participants as noted below.
         a. What are the characteristics and barriers of the people you will actually include in your program?

           b. How many individuals will you serve?

   3. What results are you committed to achieving, meaning change in participant behavior and/or condition, and for
      how many persons?

   4. How will you know when your results have been achieved? What information or evidence will you use to verify

   5. Half way through your project, what key behaviors or changes in condition will you look for to know if participants
      are on course to achieve results?

   6. Describe the achievements of your past participants? What % of your participants achieved the result in the past
      3 years? If this is a new program, describe participant achievement of the modeled approach or similar program.

   7. Who is the person or persons who will lead the project to its results? What factors in that leader most predict
      participant success?

2011 Grant Application (Longleaf)
   8. Are any partners critical to your success? If so, please list them, describe the role they must play and their
      evidence of commitment.

   9. If you do not receive full grant funds for this application, how will that impact your ability to achieve the results

2011 Grant Application (Longleaf)
                                        THE LONGLEAF FUND

                                            2011 Project Budget Form

Project Name:
                                                                 Enter C or R                 For Post Grant Use Only
Funding Sources: List each actual and/or                         Committed              Actual       Interim       Final
anticipated source of funding for this                               Or               Amount of      Report       Report
project ONLY. Include all in-kind support            Amount      Requested             Funding       Amount       Amount
worth >10% of total project budget.                                                   Received      Remaining    Remaining
The Longleaf Fund Grant (Box 1)                                         R

Total Project Income (Box 2)                     $                                $

                                                                                                For Post Grant Use Only
Expense Items: List expense items for                                    Amount of item           Interim      Final Report
this project. On a separate page, provide                               funded from this           Report        Amount
brief descriptions of any items which are            Amount                  grant                Amount          Spent
not self-explanatory.                                                                              Spent

Total Project Expense                        $                      $

                                                 Same as Box 2              Same as Box 1

Anticipated deviations against any line item require reallocation requests to be approved by the Committee
before reallocation of funds. Please submit reallocation requests in writing to FFTC.

2011 Grant Application (Longleaf)

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