Preparing Transitional Age Youth for Their Futures.

Transcription

1 Lyndsey Crisenbery CASA of the High Plains, Inc. Preparing Transitional Age Youth for Their Futures. Requests of more than $5,000 CASA of the High Plains, Inc. Mrs. Lyndsey Crisenbery 107 W. 13th Hays, KS O: Mrs. Lyndsey Crisenbery 107 W. 13th Hays, KS O: Printed On: 21 December 2017 Requests of more than $5,000 1

2 Lyndsey Crisenbery CASA of the High Plains, Inc. Application Form Organization Information Verification of tax-exempt status* Organization is: 501(c)(3) public charity Verification of status Please note: Applications from public charities (501(c)3 organizations) are required to attach verification of charitable status in order to be considered. A state sales tax exemption DOES NOT complete this requirement. Applications from churches and/or government entities are not required to attach a verification document. 501(C) 3.pdf Physical Address If the physical address of your organization is different than the mailing address, please enter your physical address below. NA Project Information Project Name* Name of Project. Preparing Transitional Age Youth for Their Futures. Amount requested* $28, Primary objectives* The Foundation has six primary objectives. Which of these does your program or project best addresses: Community Social Services & Security Printed On: 21 December 2017 Requests of more than $5,000 2

3 Lyndsey Crisenbery CASA of the High Plains, Inc. County or Counties Served* Please check the primary county served by the program/project for which you are requesting funds. Ellis Gove Rooks Trego Communities Served* Please list the primary community served by the program/project for which you are requesting funds. CASA of the High Plains serves children in the 23rd Judicial District, which includes Ellis, Rooks. Trego, and Gove counties. Funding from this grant would help to assist each county, however due to the size of Ellis County, the majority of the funding would be spent in Ellis county. Strategic Doing Project* Was this application generated through the Strategic Doing initiative? No Target Population* Please check one or more populations served by the program/project for which you are requesting funds. Early Childhood (0-4) Youth (5-12) Teen (13-20) Project Description* Briefly describe the program/project for which you are requesting funds. It has become very evident at the local, state, and national level that children exiting the foster care system are not prepared to enter adulthood. The road to adulthood is challenging for anyone, but for youth in foster care it can be especially lonely, confusing, and uncertain. In spite of facing significant challenges, youth involved in the foster care system demonstrate courage, determination, and resilience. It is important to provide these youth, and the volunteers who work with them, the resources and assistance needed to achieve stability and independence. CASA would like to hire a part time Transitional Youth Specialist to help ensure that the children CASA serves between the ages of have the tools they need in order to exit foster care and enter adulthood as productive members of society. The specialist would be responsible for ensuring CASA volunteers are trained and prepared to assist youth entering adulthood. The specialist would manage transitional youth s files, ensure pre and post assessments are completed, and identify resources to assist individual children, ensuring that they are more prepared for adulthood then they were when they entered our agency. The pre and post assessments will tell us if a child knows how to write a resume, locate their social security number and birth certificate, apply for a job, and other topics relevant to aging out of the system. The specialist and volunteers will use the data completed in the assessment to identify areas the child may need to grow, and provide education and resources to the youth to ensure they have the tools they need. Printed On: 21 December 2017 Requests of more than $5,000 3

4 Lyndsey Crisenbery CASA of the High Plains, Inc. Grant Request Description* If funded, how will you specifically use the Dane G. Hansen funds? Hire a part-time Transitional Youth Specialist. Provide training to specialist and volunteers. Volunteer recruitment. Executive Director (8 hours per week) for superivsing Transitional Youth Specialist. Project Objectives* What do you hope to achieve and how will it benefit the people of Northwest Kansas? Goal: To prepare transitional age youth for exiting foster care and entering adulthood as productive members of society. Ensuring children in our community are prepared to leave foster care, and lead responsible lives helps our communities to grow, and saves money, and reduces the likelihood of a crime committed by one of these children. Objective 1) By March 2018 high Transitional Youth Specialist to ensure that children 14 and above are prepared to become adults and productive members of society. Objective 2) Ensure at least 75% of all youth 14 and above receive the pre-assessment to determine what resources they need. This assessment may be provided to all youth 14 and above by May for youth already in CASA's program, and will be given within one month of entering our program for new youth. Objective 3) Ensure at least 75% of youth 14 and above that completed the pre-assessment complete the post the assessment. Assessment will be completed during their completion with CASA or by March 30, 2019, whichever comes first. Youth that enter the CASA program in January, February, and March of 2019, will not be required to complete the post assessment by March 30, Objective 4) 75% of youth that completed the pre and post assessment will show an increase in preparedness for adulthood per the assessment results. Timetable for the Project* When is the project projected to begin and end? For ongoing projects, when will the Dane G. Hansen funds be utilized? This project will beginning March 1, 2018 and will be completed in February 28, Funds will be used on a bi-weekly basis to cover salaries, and training cost. March-Hire Transitional Youth Specialist. April- Complete pre-assessment on current children, and provide training to volunteers and staff on transitional youth. May-February- Continue to collect pre and post assessments as appropriate. Provide services to children as needed to help them become responsible members of society. Printed On: 21 December 2017 Requests of more than $5,000 4

5 Lyndsey Crisenbery CASA of the High Plains, Inc. Additional Support Describe additional sources of support (if any) that have been secured or that will be pursued for this project. Josh Tanguay, LMLP with Clinical Associates in Hays has agreed to provide CASA volunteers trainings in regards to mental health and supports needed for this age group. The current Executive Director is completing her degree with the Master's Social Work program with KU, with her degree she is also participating the Integrated Behavioral Health with At-Risk Adolescents and Transition-Age Youth Scholars program, and will be able to provide a great deal of support to the Transitional Youth Specialist. Evaluation* How will you evaluate the success of the project/program? Be specific. (If funded, this will be helpful when completing the final grant report.) Success in this program will be based on the pre and post assessments completed by both youth and volunteers, which will determine if the youth progressed in their readiness for transitioning from foster care to adulthood. Sustainability* How will the project/program be sustained in the future? (For capital projects, how will you maintain or operate the item or facility?) Should this project be successful CASA will continue to look for grants to help support it. CASA will increase fundraising and grant efforts in order to secure the program. Supporting Documents Proposal Budget* Complete the budget form attached on the Grant Criteria page under document requirements and upload here. DGH-Budget-Sheet (2) (8).xlsx Balance Sheet* A detailed financial statement is required. Please do not attach your entire audit report. An example can be found on the Grant Criteria page, under document requirements. Balance sheet.pdf Income Statement* A detailed financial statement is required. Please do not attach your entire audit report. An example can be found on the Grant Criteria page, under document requirements. Printed On: 21 December 2017 Requests of more than $5,000 5

6 Lyndsey Crisenbery CASA of the High Plains, Inc. Profit Loss.pdf Board of Directors* Please attach a list of your board members. (Name and title, no biographies.) current board list xlsx Bid or Quote A copy of the bid or quote is required for a capital project or purchase. Letter of Support 1 A letter of support may be attached, but is not required. Letter of Support 2 A second letter of support may be attached, but is not required. Letter of Support 3 A third letter of support may be attached, but is not required. Additional Documents If there are additional documents that are critical to the trustees understanding of your proposal, upload them here. Electronic Signature Signature of Applicant* By entering my full legal name here, I warrant the truthfulness of the information provided in this application. Lyndsey Crisenbery Title of Applicant* Executive Director Signature of Principal or College President (if required) By entering my full legal name here, I warrant that I have read and support this application. Title of Principal or College President Printed On: 21 December 2017 Requests of more than $5,000 6

7 Lyndsey Crisenbery CASA of the High Plains, Inc. Signature of CEO, Director, Mayor, etc. If this request is for a City, 501 (c)(3) Organization, Government Entity, etc., the signature of the CEO, Director, Mayor, etc., is required. By entering my full legal name here, I warrant that I have read and support this application. Lyndsey Crisenbery Title of CEO, Director, Mayor, etc. Executive Director Internal Tracking Number* c3* Yes Printed On: 21 December 2017 Requests of more than $5,000 7

8 Lyndsey Crisenbery CASA of the High Plains, Inc. File Attachment Summary Applicant File Uploads 501(C) 3.pdf DGH-Budget-Sheet (2) (8).xlsx Balance sheet.pdf Profit Loss.pdf current board list xlsx Printed On: 21 December 2017 Requests of more than $5,000 8

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10 Dane G. Hansen Project Budget Form Organization: CASA of the High Plains, Inc. Project name: Preparing Transitional Age Youth for Their Futures. List project expenses (be specific) Transitional Youth Specialist $17, Executive Director- Grant Supervisor hrs. per week $10, Training $ *Total Project Expenses $28, Project Revenue Secured Applied-for Earned Budgeted funds, (Grants, Pending (Fees, ticket In-kind donations can be included- provide equitable dollar amount. gifts received, etc donations) sales, etc) Dane G. Hansen Foundation Request $28, TOTALS $28, *Total Project Revenue $28, *Revenue and Expense totals should be the same.

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12 6:15 AM CASA of the High Plains, Inc. 11/28/17 Balance Sheet Accrual Basis As of October 31, 2017 Oct 31, 17 Sep 30, 17 $ Change Oct 31, 16 $ Change ASSETS Current Assets Checking/Savings Checking 12, , , , , Money Market 4, , , , CD Aug & Feb 4, , , CD Sept & March 4, , , CD Oct & Apr 4, , , CD Nov & May 4, , , CD Dec & June 4, , , CD Jan & July 4, , , Total Checking/Savings 44, , , , , Total Current Assets 44, , , , , Fixed Assets Equipment 10, , , Accumulated Depreciation -9, , , , Total Fixed Assets , , TOTAL ASSETS 45, , , , , LIABILITIES & EQUITY Liabilities Current Liabilities Other Current Liabilities Payroll Liabilities 1, , Total Other Current Liabilities 1, , Total Current Liabilities 1, , Total Liabilities 1, , Equity Retained Earnings 37, , , , Net Income 6, , , , , Total Equity 43, , , , , TOTAL LIABILITIES & EQUITY 45, , , , , Page 1

13 6:16 AM CASA of the High Plains, Inc. 11/28/17 Profit & Loss Accrual Basis January through October 2017 Jan - Oct 17 Jan - Oct 16 $ Change Ordinary Income/Expense Income Reimbursements State of KS Dept. of Admin Reimbursements - Other Total Reimbursements , Donations 4, , Rent Income County Income Rooks 3, , Trego County Total County Income 3, , Fund Raisers Fundraiser Board Comedy Event Sponsorships , , Valentines Dinner & Dance-Feb Casa for CASA Donation , Tickets/Auction 15, , , Sponsor 2, , , Total Casa for CASA 18, , Sponsor Tickets Valentines Dinner & Dance-Feb - Other Total Valentines Dinner & Dance-Feb 18, , , No Show Tea Total Fund Raisers 19, , , Allocations Kansas CASA 1, , , Kiwanis , Total Allocations 2, , , Grants Greater Salina Comm. Foundation 2, , United Way Allocation 19, , City of Hays 7, , , Kansas Permanent Family 8, , , Walmart Grants - Other , , Total Grants 38, , , Total Income 67, , , Expense Background Checks Volunteer Training Child Needs Gifts and Memorials Fund Raising Activities Comedy Event Advertising Comedian Fee , , Total Comedy Event , , Valentines Dinner Credit Card Charge Casa for CASA Expense Page 1

14 6:16 AM CASA of the High Plains, Inc. 11/28/17 Profit & Loss Accrual Basis January through October 2017 Jan - Oct 17 Jan - Oct 16 $ Change Materials Total Casa for CASA Expense Supplies 1, Advertising 1, Auction Items Printing 1, , Food 1, , Bar Valentines Dinner - Other Total Valentines Dinner 5, , Total Fund Raising Activities 5, , , Advertising Community Awareness , , Advertising - Other Total Advertising , , Membership Dues Misc. Expenses Salaries 37, , , Staff Training Bank Service Charges Contributions Depreciation Expense 1, , Dues and Subscriptions 1, Insurance Worker's Compensation Insurance Total Insurance Interest Expense Postage and Delivery Professional Fees Accounting , , Professional Fees - Other Total Professional Fees , Rent 5, , Telephone 1, , Travel & Ent Meals Travel 1, , Total Travel & Ent 1, , Utilities Gas and Electric 1, , Total Utilities 1, , Office Supplies 1, , Payroll Taxes 3, , Supplies Office Supplies - Other , , Total Supplies , , Total Expense 60, , , Net Ordinary Income 6, , , Other Income/Expense Other Income Interest Income Page 2

15 6:16 AM CASA of the High Plains, Inc. 11/28/17 Profit & Loss Accrual Basis January through October 2017 Jan - Oct 17 Jan - Oct 16 $ Change Other Income Total Other Income Net Other Income Net Income 6, , , Page 3

16 CASA of the High Plains, Inc. List of Board of Directors AS OF 10/01/2017 Title KBI DCF Name Address Phone Appt. Date End of 1st Term End of 2nd Term President x x Marie Wegele 104 E. 20th St. Hays, KS Jul-15 Jun-18 Vice President x x Michael Baxter 1314 E. 18th, Hays, KS /1/2015 7/31/2018 Treasurer x x Meagan Wellbrock 703 Sunset, Victoria, KS Jan-15 Dec-17 Secretary x x Darci A. Cain 2013 Walnut, Ellis, KS Jan-15 Dec-17 Head of Fundraising x x Raymond Haas 1601 E 22nd St, Hays KS (H) Jan-13 Dec-15 Dec Board Member x x Cristina Janney 505 W. 36th Apt. D, Hays, KS Sep-17 Board Member X X April Terry 512 W. 31st. St. Hays, KS Sep-17

17 CASA of the High Plains, Inc. List of Board of Directors AS OF 10/01/2017

18 Current Board List as of 1/28/2014 Title KBI DCF Name Address Phone President x x John Raacke 2200 Ash St., Hays, KS (H) Vice President x x Doug Minson th Ave., Wakeeney, KS (M) Treasurer x x Brett Henry 2511 E 21st St., Hays, KS (H) Secretary x x Renee Dreiling 1557 HILLTOP DR, Hays, KS (H) Board Member x x Brenda Gable 2404 Indian Trail, Hays, KS (H) Board Member x x Sue Niernberger 324 W 33rd St., Hays, KS (M) Board Member x x Elodie Jones 1414 W 45th St., Hays, KS (M) Board Member x x Michelle Rounsley 709 N Jefferson, Plainville, KS (M) Board Member x x Raymond Haas 1601 E 22nd St, Hays KS (H)