Rochester Area Common Application Form

Application Content

                   

Please note:     A. Applications should be legible.  Handwritten in black ink, word processed or typed.

                        B. “Organization” = group whose 501(c)(3) status is being used.

 

A complete application will include items 1-10.  Some funders will accept a “short form” omitting items 3 and 4.  Please refer to the Information for Grantseekers cover sheet for additional information or contact the grantmaker.

 

1.       Executive Summary (This takes the place of a cover letter.)  Please create in bulleted rather than narrative form.  To save time, we suggest that you wait until after completing the rest of the proposal to develop this section.  We encourage you to limit this to one page or less.  It should be a brief synopsis of your request, able to serve as a stand-alone piece.

 

  1. Organization name
  2. 1. Project/activity name

2. One sentence summary of project/activity

  1. For this request, summarize:

1.       Why (community need)

2.       Who and how many (target population, including age, gender, ethnicity, other relevant characteristics)

3.       What (services provided)

4.       When (timeframe)

5.       Where (location of the work)

D.     What do you hope to accomplish (outcomes)?

  1. How does this request meet this funder’s priorities?
  2. State the total cost of this effort, and the amount requested from this funder.
  3. Signatures of CEO and a board representative, preferably the board chair or president.

 

2.       Information sheet (use attached form).

 

3.       Logic model (use attached form and instructions).

 

4.       Rationale (follow attached instructions).

 

5.       Program or Project Budget sheet (use attached form).

 

6.       Financial summary of your organization’s most recently completed fiscal year, including the original budget and actual revenue and expenses for that year.

 

7.       If you are a 501(c)(3) organization, a copy of the IRS determination letter advising that your organization is exempt from taxes under Section 501(c)(3) of the IRS code, and that the organization is not a private foundation as defined in Section 509(a).

 

8.       Listing of organization’s Board of Directors with their affiliations.

 

9.       Most recent audited financial statement and accompanying management letter for a complete fiscal year of the organization.  If your financial statements have never been audited, indicate why – e.g. you are too small, or your organization is too new.

 

Annual report, if available, or a brief description of the scope of your organization’s work.