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1 GRANT PROPOSAL SUMMARY (Please submit a signed original of this page and TWELVE (12) copies) This is the ONLY page that requires twelve copies. Organization: Founding date: Address: Telephone: Grant Focus Area #: Website: Organization s General Contact person: Telephone: Contact person s Attended Grant Information Session 2/21/18 Purpose of the organization: Name of the project to be funded: Project dates: Beginning Ending Total project budget $ Amount of this request $ Brief description of the project: Use of requested funds: Geographic area served by project: Population to be served (number & description): Adams County residents to be served (number & description): Print Name of CEO/Exec. Dir./Superintendent Print Name of Board President CEO/Exec. Dir./Superintendent Signature Date Board President Signature Date p 1 of 6 (rev. Jan 2018)

2 Instructions for Completing the ACCF Grant Proposal Summary Page: The form must be completed in full and the signed original submitted with twelve (12) copies. Please do not complete a line by referring to information found elsewhere in the grant packet. You may retype the summary page in order to complete it, but it must remain only one (1) page long. Organization: Please use the full legal name of the nonprofit organization to which the check will be written if the grant is approved. This is the organization name as it appears on the IRS Letter of Determination of 501(c)(3) status. If you do business under another name, submit supporting documentation. Contact person: The person who can answer questions about the grant should any arise. If that person s telephone number is different from the telephone number listed for the organization, please list the telephone number of the contact person next to that person s name. Purpose of the organization: The mission, what the organization exists to do. Project budget: The total cost that the organization will incur to complete the project. This total should match the total on the Project Budget page. Amount of this request: Maximum grant amount is $15,000. Brief description of the project: Exactly what this project is or intends to do. Use of the requested funds: What the funds of the Adams County Community Foundation will be used to pay for. Geographic area served: Identifies the specific communities that the project will serve. You should include number of people. Population to be served: Describes the type of people who will be served and tells the number of people who will directly benefit from the project. While an organization s services may be available to all 115,000 people in the county, only certain people will directly benefit. How many realistically do you expect will directly benefit from the project? Adams County residents to be served: Some projects serve more than one county. In those cases, how many Adams County people will directly benefit from the project? Please do not duplicate persons, but describe your situation so that the full level of service is understood. One person served ten times is 1 person; not 10. A food bank might say, 100 unduplicated individuals will receive 6 meals per visit, with an average # of 5 visits per year. Questions? Call Lisa Donohoe (717) or lisa@adamscountycf.org p 2 of 6

3 MISSION STATEMENT The purpose of Adams County Community Foundation is to inspire people and communities to build and distribute charitable funds For good, for Adams County, for ever. GUIDELINES Please note that grant guidelines changed in 2018 in order to provide strategic focus. The Adams County Community Foundation has focused its 2018 Adams County Grants program on three areas based on recent community needs assessments, the availability of other community-based competitive grants and opportunities available to all nonprofits through individual giving: 1. Help nonprofits become efficient and effective at what they do by making grants of up to $15,000 to build the capacity of nonprofits that address the needs of our most vulnerable residents, with special consideration to those addressing affordable housing, transportation and youth. 2. Make a meaningful and sustained difference in people s lives through grants of up to $15,000 to nonprofit organizations that help low-income residents move toward self-sufficiency. 3. Build a healthier community through grants of up to $15,000 for collaborative projects that address youth activities or transportation or affordable housing issues. Application forms are available at Please do not submit your proposal packet in a binder or folder. Use paper clips or binder clips rather than staples. The Adams County Grants program will not: Fund organizations outside Adams County, unless it can be clearly demonstrated that Adams County residents will benefit from the funds requested, Retire debt, Support fund raising events, endowment drives. Applications for Capital Campaigns: Please call (717) to discuss your project and request the Capital Campaign Application packet if your request is for building, or major renovation costs, or major equipment. p 3 of 6

4 Grant proposals will include: Organization s 501(c)(3) letter of determination from the IRS A completed, signed Grant Proposal Summary with twelve (12) copies A narrative and one copy which includes an expanded explanation of the purpose of the organization, the description of the project and the use of the funds, and an evaluation process for the project. The narrative should be no more than 5 pages, 12 pt. type, single spaced, on letter size paper. Include the headings as shown on page 5 at the beginning of each paragraph. A time line for implementation of the project. Tabs on the online form allow you to choose to report either by calendar or fiscal year. A budget for the organization (Please adapt line items on budget form provided. 3 years comparison.) A budget for the project (Please adapt line items on budget form provided.) The most recent Form 990 and independent financial audit or financial statement (only if an audit is not done). These may be stapled. A list of Board members with each member s professional affiliation and town and state of residence Please mail your proposal to: Lisa Donohoe, Director of Community Programs Adams County Community Foundation 25 S. Fourth Street Gettysburg, PA Please do NOT drop off your proposal at our office or it. Mail your proposal to receive a postmark on or before the due date, please. Questions? Call (717) or lisa@adamscountycf.org p 4 of 6

5 NARRATIVE FORMAT ORGANIZATION OVERVIEW (Brief) Mission, Clients served (type and number), Accomplishments, Community support/collaborations and any supporting information about your organization. DEFINITION OF THE PROJECT Briefly describe the project for which you are requesting funding. Complete the timeline form provided. Select tab for fiscal or calendar year. NEED/PROBLEM TO BE ADDRESSED BY THE PROJECT What is the community need this project will address? If you are serving a target population of people, such as students, what need of theirs are you addressing? PEOPLE & OTHER INPUTS What people specific staff or volunteers will be involved in overseeing and implementing this project? How are they qualified to do this work? What other resources are needed facilities, equipment and supplies? ACTIVITIES/STRATEGIES How will you accomplish the desired outcomes? Measure staff activity What specifically will you do (services) to accomplish the desired outcomes? PROGRAM OUTCOMES What outcomes do you expect to achieve? What will be better or improved because of this project? Describe how outcomes will be measured. What standards have you established to measure benefits obtained by clients (indicators) and level of achievement of this project? How will you evaluate whether or not you accomplished your outcomes? FUNDING What other funding sources will you go to for money or other resources for this project? What funding will sustain this project in the future? How does your board financially support your organization? OTHER If there is any other information you would like to offer to support your request, please include it here. Please do not send your organization s brochures. Use these headings in your narrative. Submit one (1) original (up to 5 typed pages, single-spaced, 12 point type) and one copy. p 5 of 6

6 PROPOSAL CHECKLIST ORGANIZATION: DATE: Grant Proposal Summary (submit the signed original plus twelve (12) copies of this page) Narrative (submit the Original and one (1) copy of the narrative section) Organization Overview Definition of the Project Need/Problem to be Addressed by the Project People & Other Inputs Activities/Strategies Project Outcomes Funding Other: Submit one of each: Time Line Organization Budget - Use our format. Select the appropriate tab. Change line items to reflect your particular sources of revenue and types of expenses. Provide 3 years comparison. Project Budget - Include Revenue in the top portion and Expenses on the lower portion. Change line items to reflect your particular sources of revenue and types of expenses Audit/990/Financial Statement Board List/Advisory Board List IRS Letter of Determination of 501(c)(3) status Explain if none Other items pertinent to your proposal may include: job descriptions, strategic plans, board resolutions, estimates, approvals, agreements, memorandums of understanding, etc. Letters of Support (only required for projects involving partnership or collaboration with other organizations) p 6 of 6

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