• GRANT APPLICATION FORM

  • PROPOSAL COVER PAGE

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  • SECTION A:

    PROGRAM NARRATIVE
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  • a. Describe the key components of your program in a manner that demonstrates how it will respond to an identified community need. Emphasize any critical or unique services provided by your program.

    b. How many clients do you expect to directly serve with this program in the grant year?

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  • a. Describe the population your program is designed to serve in order to address the above identified community need (for example, general demographic information such as gender, socioeconomic status, racial/ethnic mix of current program participants). Describe the extent to which this program serves diverse populations.

    b. Describe any eligibility criteria you use to determine who to serve within the program (for example, age, income, health status, disability status, etc.).

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  • Explain any issues, challenges and/or barriers affecting the population you propose to serve and the impact your program will have to address this need. Include key indicators, current baseline data and a brief explanation of what is causing the current unacceptable results.

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  • a. Identify your key organizational partners and describe how you will collaborate with them to deliver your program and achieve results for the target population.


    b. Describe how your agency interfaces with other services/resources to provide a referral network for your clients.


    c. Do other agencies/programs in the community provide services similar to this program?

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  • a. Describe what your agency is doing to attract, develop and leverage a variety of financial, volunteer and other in-kind resources to support this program.


    b. Does your agency have other committed sources of funding that will support the sustainability of this program?

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  • a. Describe the strategies and methods your program will use to ensure and monitor quality for this program. These may include, but are not limited to, the following:


    I. Statistical information on the research base for your program
    II. Program philosophy and service delivery standards (for example, client/staff ratio)
    III. Prior experience with the program and/or client population
    IV. Prior evaluations/results of the program
    V. Involvement/empowerment of clients in program design, evaluation and/or decision-making, volunteering, mentoring others, etc.


    b. Describe the qualifications and training of program staff (and, if applicable, program volunteers).


    c. If this is an existing program, provide data (for the past 1-5 years) to support your long-term performance. Describe how your program used these performance measures and results to monitor and improve program capacity, quality and results. Include any lessons learned, challenges experienced and program changes or improvement made.

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  • Summarize the goals of your program and how you will measure the program’s success. State any quantifiable success metrics your program hopes to achieve and timelines to attain those goals.

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  • a. What percent of your board of directors provides a financial gift to your organization annually?


    b. If 100% of your board of directors does not give annually, please explain why.

  • SECTION B:

    BUDGET NARRATIVE (1 page limit)
  • 11. Download and complete the Program Budget Worksheet for the period July 1, 2020-June 30, 2021. See the ‘Budget Worksheet Instructions’ document for more detailed instructions.

    a. Column B: Report only the revenue and expenses that will be covered by funding requested from FHWF.
    b. Column C: Report the revenue and expenses that will be covered by funds other than those requested by FHWF.
    c. Column D: Please indicate “C” (Committed) or “R” (Requested) for each revenue source.
    d. Column E: Totals are calculated automatically.
    e. Column F: Percentages are calculated automatically.

  • 12. List the following amounts from your completed Program Budget Worksheet:

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  • 13. Summarize the expenses that will be covered by the FHWF funding if approved.

  • SECTION C:

    Appendices and Additional Documents
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