CATHOLIC CAMPAIGN FOR HUMAN DEVELOPMENT APPLICATION FOR LOCAL GRANTS ARCHDIOCESE OF OKLAHOMA CITY

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APPLICATION FOR LOCAL GRANTS ARCHDIOCESE OF OKLAHOMA CITY CAREFULLY READ CRITERIA FOR APPLYING COMPLETELY FILL OUT APPLICATION AND MAIL/FAX TO CCHD Local Committee Becky VanPool 1501 N. Classen Boulevard Oklahoma City, OK 73106 405-523-3009 FAX 405-523-3030 APPLICATIONS MUST BE POSTMARKED/FAXED BY September 1, 2015 The Catholic Campaign for Human Development is the domestic anti-poverty, social justice program of the US Catholic Bishops. Its mission is to address the root causes of poverty in the US through promotion and support of community-controlled, self-help organizations and through transformative education. An annual collection to support the Campaign is taken each year in US Catholic parishes on the weekend before Thanksgiving. One-fourth of the money collected remains within the Archdiocese to fund local grants, while the remaining three-fourths funds national grants. These grants provide seed money for parish/organization based efforts that foster human development. PLEASE NOTE: Grant requests are usually in the range of $500-$2,000. Applications must be filled out completely, legibly, and accurately. Multiple applications from one parish/organization must be prioritized. Please note 1 st, 2 nd, 3 rd priority on front of application. All requests must be signed by all appropriate persons. Applications without the signature of the pastor will not be considered. 1

CRITERIA ~ LOCAL GRANTS 1. Funding is primarily for parish and Catholic School projects that promote human development. Funding is for assistance in project start-up. 2. Projects should be those which empower persons, provide for social needs, and/or address the root causes of injustice and poverty. 3. Projects should demonstrate both: parish involvement with the support of the pastor; involvement of persons being served 4. Grant funds are intended to be foundation monies only and not provide total support for the on-going needs of the project. 5. Funded proposals will receive grant monies in two payments. Grant recipients must submit an interim report, photographs of the activities of the project, and photo release forms to receive second half of the grant. 6. Interim report note: If project does not proceed as proposed, use interim report to give update. 2015-2016TIMELINE FOR APPLICATIONS AND FUNDING Applications will be available July 1, 2015. Applications due/postmarked September 1, 2015. Funding decisions made during September 2015. Initial disbursement of funds will be in September 2015. Interim Report due on or before February 1, 2016 Final Report due August 1, 2016 Remainder of funds disbursed upon receipt of interim report, photographs, and photo release form. For funds disbursed in September, this report is due February 1, 2016. Initial disbursements requested after September 1 require a progress report within 4 months. Failure to submit a timely progress report will jeopardize approval for future funding. 2

APPLICATION FOR LOCAL GRANTS Project Title: Sponsoring Parish: Parish Address: City, State, Zip: Telephone [Area Code + Number]: FAX [Area Code + Number]: Contact Person: Street Address: City, State, Zip: E-mail: Telephone: FAX: Grant Amount Requested: Timeline for Proposed Project: Have you received previous grants from this fund? Yes No If yes, have you returned the Interim or Final Progress Report? Yes No of Report: 3

1. Purpose Statement of Project: 2. Identify the goal(s)/objective(s) for the funds requested. Projects are intended to be those which empower persons and provide for social needs, and/or address the root causes of poverty or injustice. 3. A. Clearly describe how the parish (which group and/or parishioners) is involved in the planning/carrying out of the project: B. Clearly describe how those persons being served are involved in the design and implementation of the project. 4. Budget - complete form provided on p. 5. 5. Progress Report(s) complete form provided at appropriate times. Note: attach additional pages, if needed, to complete any question. 4

PROJECT BUDGET ~ LOCAL GRANTS Project Name: PROJECT INCOME BUDGET INTERIM FINAL List all sources AMOUNT Grant Request amount TOTAL INCOME PROJECT EXPENSES TOTAL EXPENSES BUDGET BALANCE VALUE IN-KIND SUPPORT List Sources (Examples: Staff & Volunteer Time, Meeting Space, Printing, etc.) Budget Completed By 5

SIGNATURE PAGE ~ LOCAL GRANTS Please review your application to ensure that all information is provided. If you have any questions, please call Becky VanPool, 405-523-3003. An incomplete application will not be considered. We have completed and/or reviewed this application. We are in support of the project. Signature of Person Submitting Proposal Parish Group Responsible for Project Signature of Principal [if applicable] Signature of Pastor Project Submitted/Mailed/Faxed on Chairperson 6

PLEASE RETAIN THIS FORM. DO NOT SUBMIT WITH INITIAL APPLICATION. IF GRANT IS RECEIVED, SUBMIT THIS FORM BY FEBRUARY 1, 2016 OR WITHIN 4 MONTHS OF INITIAL DISBURSEMENT OF FUNDS. SUBMIT FINAL EVALUATION NO LATER THAN AUGUST 1, 2016 IF NOT SUBMITTED EARLIER. Authorization and release attached form from those in photographs. Photographs included or sent electronically. Budget report attached with priest signature. Evaluation attached. 7

PROGRESS REPORT(S) ~ LOCAL GRANTS Interim Report Final Report Instructions: An Interim Progress Report must be filed on or before February 1, 2016 for funds requested September 2015. For initial requests after September, interim report is due within 4 months of disbursement of funds. The Interim Progress Report must be accompanied by an interim budget report(page 5), photographs, and a completed Authorization and Release Form from participants present in photos. If your project has been completed and all CCHD grant funds have been expended, the Interim Progress Report may be considered the Final Report. For ongoing projects, a Final Report must be submitted no later than August 1, 2016. Approval of future grants will be in jeopardy if the sponsoring parish has failed to file an Interim Report (or Final Report). Please type or print. 1. Fill out information Project Title: Sponsoring Parish: Address: Contact Person: Telephone: E-mail: FAX: Grant Amount $ Amount utilized: Not used: 2. Attach Interim or Final budget report 3. Evaluation: Please attach an evaluation of your project that not only establishes its purpose but lists the major elements, goals, and objectives and how they are being, or were accomplished. The evaluation should also address the status of the project as well as future plans for operation. 4. Comments: Contact person signature: : Pastor signature: : 8

Authorization and Release I, the undersigned, do hereby authorized the use of photographs, which include my likeness and picture, and my name, to be use by Catholic Charities, for promotion of the Catholic Campaign for Human Development (CCHD), or other uses by Catholic Charities, in publicizing the work or project represented by the photograph. I understand that these photographs may be printed in the Sooner Catholic to publicize the annual appeal of CCHD in November, in local flyers distributed to parishes in the Archdiocese as advertisement of the work done at the parish level with the funds from the CCHD, in national brochures demonstrating the use of CCHD funds across the country, or in promotional materials relating to activities of Catholic Charities. I hereby release, and hold harmless, the Archdiocese of Oklahoma City, Catholic Charities and its employees from liability for use of the photographs and name for promotional purposes in keeping with this authorization and release. Signature Consentimiento Para Publicación de Fotografías Yo, la persona abajo firmante,, otorgo mi autorización para que Caridades Católicas haga uso de fotografías que incluyan mi imagen y que puedan ser necesitadas para promocionar la Campaña Católica para el Desarrollo Humano (conocido por sus siglas en ingles CCHD), o cualquier otra publicación o proyecto que Caridades Católicas estime conveniente. Yo comprendo que estas fotografías pueden ser publicadas durante la Campaña de Colecta Anual de la CCHD en noviembre en el Periódico Católico Sooner Catholic. También pueden ser utilizadas en publicaciones locales dirigidas a las Iglesias de la Arquidiócesis para informar acerca del trabajo realizado con los fondos de CCHD a nivel parroquial o en trípticos distribuidos a nivel nacional que informen acerca del uso de los fondos de CCHD en todo el país; o en materiales promocionales que tenga relación con Caridades Católicas. Yo libero y exonero a la Arquidiócesis de la ciudad de Oklahoma, a Caridades Católicas y a sus empleados y representantes de cualquier obligación o responsabilidad asociadas con el uso de estas fotografías para los propósitos promocionales explicados en este documento. Firma Fecha 9