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HomeMy WebLinkAboutAgenda_SPCS_05.02.2022Notice of Meeting for the Strategic P artnerships for Community Serv ices Adv isory Board of the City of Georgetown May 2, 2022 at 4:00 P M at City Hall Community Room, 808 Martin L uther K ing Jr. St., Georgetown, Texas 78626 T he C ity of G eorgetown is committed to compliance with the Americans with Disabilities Act (ADA). If you require as s is tance in partic ipating at a public meeting due to a disability, as defined under the ADA, reas onable as s is tance, adaptations , or ac commodations will be provided upon request. P leas e c ontact the C ity S ec retary's O ffic e, at leas t three (3) days prior to the sc heduled meeting date, at (512) 930-3652 or C ity Hall at 808 Martin Luther King Jr. S treet, G eorgetown, T X 78626 for additional information; T T Y users route through R elay Texas at 711. Regular Session (T his R egular S es s ion may, at any time, be rec es s ed to c onvene an Exec utive S es s ion for any purpose authorized by the O pen Meetings Act, Texas G overnment C ode 551.) A R oll C all --P aul S ec ord, S P C S Advisory Board C hair B C all to O rder--P aul S ec ord, S P C S Advisory Board C hair C C ons ideration and possible action to approve the Minutes from the Marc h 29, 2022 S P C S Advis ory Board Meeting and April 5, 2022 Works hop — Alexia G riffin, S P C S Advis ory Board S ecretary D Disc ussion and possible action regarding pos s ible revis ions and/or updates to the C ity of G eorgetown S trategic P artners hips for C ommunity S ervic es G rant Application, Logic Model, and P rogram Budget Template for us e during the F Y 2022-23 grant c yc le--S hirley J. R inn, Board Liaison E C ons ideration and possible action to s et dates and times for F Y 2022-23 P artners hips for C ommunity S ervices Advis ory Board Meetings --P aul S ecord, S P C S Board C hair Adjournment Adjourn Ce rtificate of Posting I, R obyn Densmore, C ity S ecretary for the C ity of G eorgetown, Texas, do hereby c ertify that this Notic e of Meeting was posted at C ity Hall, 808 Martin Luther King Jr. S treet, G eorgetown, T X 78626, a plac e readily acc es s ible to the general public as required by law, on the _____ day of _________________, 2022, at __________, and remained s o posted for at leas t 72 c ontinuous hours prec eding the s cheduled time of said meeting. __________________________________ R obyn Dens more, C ity S ec retary Page 1 of 143 City of Georgetown, Texas Strategic Partnerships for Community Services May 2, 2022 S UB J E C T: C onsideration and pos s ible ac tion to approve the Minutes from the March 29, 2022 S P C S Advisory Board Meeting and April 5, 2022 Workshop — Alexia G riffin, S P C S Advisory Board S ec retary IT E M S UMMARY: F IN AN C IAL IMPAC T: None S UB MIT T E D B Y: S hirley J. R inn for Alexia G riffin, S P C S Advis ory Board S ecretary AT TAC H ME N T S: Description Type DRAFT Workshop Minutes Backup Material DRAFT Minutes Backup Material DRAFT Minutes Backup Material Page 2 of 143 Strategic Partnerships for Community Services Advisory Board Workshop Minutes - April 5, 2022 Page 1 of 5 Minutes of the Meeting of the Strat egic Partnerships for Community Services Advisory Board City of Georgetown, Texas April 5, 2022 The Strategic Partnerships for Community Services Advisory Board of the City of Georgetown, Texas, met on Tuesday, April 5, 2022 at 11:00 a.m. in the City Hall Community Room located at 808 Martin Luther King Jr. St., Georgetown, Texas 78626. Members Present: Paul Secord, Alexia Griffin, Jennifer Ridings-Myhra Members Absent: Carly J. Kehoe, Jerry Huffman Staff Present: Shirley J. Rinn, Executive Assistant to the City Manager, Amy Mertink, Business Process Analyst, Seth Gipson, Performance Management Program (PMP) Manager Visitors: Jaquita Wilson, Leslie Janca, Pat Schneider, Suzy Pukys, Ginna O’Connor, Jerry Haecker MINUTES Regular Session (This Regular Session may, at any time, be recessed to convene an Executive Session for any purpose authorized by the Open Meetings Act, Texas Government Code 551.) Meeting was called to order at 11:00 a.m. A Strategic Partnerships for Community Services Grant Program Process Improvement Work Session Rinn told the group thank you for helping the City with this brainstorming session. She asked everyone to introduce themselves and which agency they were with. Rinn told them that the group included representatives from city staff, current and past members of the SPCS Advisory Board, representatives from both small and large non-profit groups in the community. Rinn, Mertink, and Gipson provided a quick overview of the business process improvement exercises that have been taking place with regard to city operations and specifically the Strategic Partnerships for Community Services Grant Application process. The group was told that city staff put together a process map that identified all of the steps involved to complete the SPCS grant application process from beginning to end. This process map was utilized to identify areas of waste within the process such as transportation, inventory, motion, waiting, overprocessing, defects, and skills, as well as identifying pain points within the process. Page 3 of 143 Strategic Partnerships for Community Services Advisory Board Workshop Minutes - April 5, 2022 Page 2 of 5 This processing map was utilized to analyze and find opportunities to improve the process and potential areas of waste and pain points were identified. A Value-add Analysis was also performed to identify steps as follows: • Value-added (VA) - Any step in the process that the customer is willing to "pay" for, experience, or endure. (The step must be done right the first time and it must transform the product or service) • Business Necessary Opportunity to Improve (BN/OTI) - Steps that include constraints introduced by an outside entity (those out of our control). We need to understand what we can and cannot change. Policy, procedures, and ordinances are within our control. We can change these; therefore, these are not BN/OTI. Examples of BN/OTI include state/federal mandates, regulations, and laws. Improvements may still be made but will have heavy constraints; ask will I get in trouble with the law? (for example) • Opportunity to Improve (OTI) - Steps that do not contribute to the product or the process and should therefore be eliminated or minimized; non value-added steps are waste. They were then told that Value-added Analysis Chart Exercise was performed to analyze the steps involved in the process and how much time is utilized to complete those steps. Page 4 of 143 Strategic Partnerships for Community Services Advisory Board Workshop Minutes - April 5, 2022 Page 3 of 5 Rinn, Mertink, and Gipson told the group who attended the meeting that they were being asked to review and brainstorm ideas based on the Process Map and the Value-added Analysis Chart to identify potential areas to improve the process. A Plus/Delta Exercise was then performed by the group to analyze the process, identify what works well with the process today, identify what should be considered for change or what doesn’t work well today, and analyze and find opportunities to improve the process. Page 5 of 143 Strategic Partnerships for Community Services Advisory Board Workshop Minutes - April 5, 2022 Page 4 of 5 An Impact/Effort Matrix was utilized to identify potential improvements and whether or not the improvement ideas were:  High Impact, Low Effort “Quick Wins”  High Impact, High Effort “Major Projects”  Low Impact, Low Effort “Low “Hanging Fruit”  Low Impact, High Effort “Revisit Later” Page 6 of 143 Strategic Partnerships for Community Services Advisory Board Workshop Minutes - April 5, 2022 Page 5 of 5 Rinn told the group thank you for participating and that their input was very valuable to this process. Adjournment Meeting was Adjourned at 12:10 p.m. ATTEST: Shirley Rinn, SPCS Advisory Board Liaison Alexia Griffin, SPCS Advisory Secretary Page 7 of 143 Minutes of the Meeting of the Strategic Partnerships for Community Services Advisory Board City of Georgetown, Texas March 29, 2022 The Strategic P artnerships for Community Services Advisory Board of the City of Georgetown, Texas, met on Tuesday, March 29, 2022 at 10:00 a.m. in the City Hall Community Room located at 808 Martin Luther King Jr. St., Georgetown, Texas 78626 Members Present: Paul Secord, Alexia Griffin, Jerry Huffman, Jennifer Ridings-Myhra Members Absent: Carly J. Kehoe Staff Present: Shirley J. Rinn, Executive Assistant to the City Manager Visitors: MINUTES Regular Session (This Regular Session may, at any time, be recessed to convene an Executive Session for any purpose authorized by the Open Meetings Act, Texas Government Code 551.) A Roll Call – Paul Secord, Advisory Board Chair All members were present except Carly J. Kehoe B Call to Order--Paul Secord, SPCS Advisory Board Chair Meeting was called to order at 10:05 a.m. C Welcome and Introduction of New Board Members – Shirley J. Rinn, SPCS Advisory Board Liaison The new and current board members introduced themselves to each other, as well as the staff liaison. D Nominations and election of Vice-Chair and Secretary of the SPCS Advisory Board. – Paul Secord, SPCS Advisory Board Chair Motion by Griffin, second by Huffman to nominate and elect Jennifer Ridings-Myhra as the Vice-Chair of the SPCS Advisory Board. (Approved 4-0) (Kehoe Absent) Motion by Huffman, second by Ridings-Myhra to nominate and elect Alexia Griffin as the Secretary of the SPCS Advisory Board (Approved 4-0) (Kehoe Absent) Page 8 of 143 E Review and discussion regarding the By-Laws for the Strategic Partnerships for Community Services and the City Council Attendance Policy for Board Members-- Shirley J. Rinn, SPCS Advisory Board Liaison Rinn went over the current by-laws and addressed the requirements of the City Council Attendance Policy. F Consideration and possible action to approve the Minutes from the August 7, 2021 SPCS Advisory Board Meeting—Shirley J. Rinn, Liaison for the SPCS Advisory Board Motion by Griffin, second by Huffman to approve the Minutes from the August 7, 2021 SPCS Advisory Board Meeting. (Approved 4-0) (Kehoe Absent) G Overview and possible action regarding the review of the grant cycle timeline, the Policy, Guidelines, Application, Evaluation and Recommendation Process for the FY 2022-23 Strategic Partnerships for Community Services Grant Cycle--Shirley J. Rinn, Board Liaison Rinn provided an overview of the history of the Strategic Partnerships for Community Services grant program. There was additional discussion regarding placing an item on a future agenda regarding bias and advisory board member experiences, and how they play a role in determining funding recommendations for the agencies who apply for the grants. There was also an extended discussion regarding the grant application itself and whether or not it is successful in providing the specific information the advisory board is looking for to make those recommendations. There was discussion regarding whether or not there was a directive from the City Council to fund all of the agencies who apply or how much they would get. Rinn told the advisory board that there was not a directive from the City Council to fund all of the agencies. She told them that the minimum grant was $10,000 and the maximum is $50,000. Rinn also clarified that the grant funds can be used for operational costs as well as programming. There was also a brief discussion regarding the funding parameters in our current policy and how they were determined. There was additional discussion regarding the number of agencies that apply and that it was up to the agencies to determine whether or not their agencies meet the funding criteria and whether or they should apply for a grant or not. There was also clarification of the reporting criteria for financials based on the size of the organization. There was discussion regarding the operational expenses being part of the program. There was also clarification that the advisory board has recommended in the past that the funding the agencies received be used for a different purpose than what they applied for. The advisory board also discussed some of the parameters and/or restrictions that have been put in place regarding the funding over the years, as well as the process for implementing them. Rinn told the advisory board that the city organization has implemented a process improvement program for all employee to look at their workload and programs to see if there are ways to improve that process. She told the advisory board that she is working with the City’s Organizational & Operations Excellence (OOE) Team to review the current process and make improvements. She told Page 9 of 143 the advisory board that she would also like to include them as well as members of the non-profit group in our community for their input as well. She also told them that all of the items that were just discussed regarding the grant application form were items that could be addressed during this process. She told them that we will be having a brainstorming workshop with the advisory board and other stakeholders on April 5, 2022 with the OOE team to review areas of improvement in the application process in order to streamline the process. Rinn also let the Advisory Board that a workshop with the City Council was scheduled in May to review the history and current criteria utilized for the SPCS Grant Program. She told them that they were more than welcome to attend the Workshop on May 10, 2022. There was additional discussion and clarification regarding the total amount of funding ($400,049) that is available for the FY 2022 grants, as well as the history of how that amount was determined. H Consideration and possible action to set dates and times for FY 2022-23 Partnerships for Community Services Advisory Board Meetings--Shirley J. Rinn, SPCS Advisory Board Liaison There was discussion regarding possible dates to have our next meetings. Rinn will send potential dates to board members to schedule the next meetings. Adjournment Motion by Griffin, second by Huffman to Adjourn. Meeting was Adjourned at 10:53 a.m. ATTEST: Shirley Rinn, SPCS Advisory Board Liaison Alexia Griffin, SPCS Advisory Board Secretary Page 10 of 143 Minutes of the Meeting of the Strategic Partnerships for Community Services Advisory Board City of Georgetown, Texas March 29, 2022 The Strategic P artnerships for Community Services Advisory Board of the City of Georgetown, Texas, met on Tuesday, March 29, 2022 at 10:00 a.m. in the City Hall Community Room located at 808 Martin Luther King Jr. St., Georgetown, Texas 78626 Members Present: Paul Secord, Alexia Griffin, Jerry Huffman, Jennifer Ridings-Myhra Members Absent: Carly J. Kehoe Staff Present: Shirley J. Rinn, Executive Assistant to the City Manager Visitors: MINUTES Regular Session (This Regular Session may, at any time, be recessed to convene an Executive Session for any purpose authorized by the Open Meetings Act, Texas Government Code 551.) A Roll Call – Paul Secord, Advisory Board Chair All members were present except Carly J. Kehoe B Call to Order--Paul Secord, SPCS Advisory Board Chair Meeting was called to order at 10:05 a.m. C Welcome and Introduction of New Board Members – Shirley J. Rinn, SPCS Advisory Board Liaison The new and current board members introduced themselves to each other, as well as the staff liaison. D Nominations and election of Vice-Chair and Secretary of the SPCS Advisory Board. – Paul Secord, SPCS Advisory Board Chair Motion by Griffin, second by Huffman to nominate and elect Jennifer Ridings-Myhra as the Vice-Chair of the SPCS Advisory Board. (Approved 4-0) (Kehoe Absent) Motion by Huffman, second by Ridings-Myhra to nominate and elect Alexia Griffin as the Secretary of the SPCS Advisory Board (Approved 4-0) (Kehoe Absent) Page 11 of 143 E Review and discussion regarding the By-Laws for the Strategic Partnerships for Community Services and the City Council Attendance Policy for Board Members-- Shirley J. Rinn, SPCS Advisory Board Liaison Rinn went over the current by-laws and addressed the requirements of the City Council Attendance Policy. F Consideration and possible action to approve the Minutes from the August 7, 2021 SPCS Advisory Board Meeting—Shirley J. Rinn, Liaison for the SPCS Advisory Board Motion by Griffin, second by Huffman to approve the Minutes from the August 7, 2021 SPCS Advisory Board Meeting. (Approved 4-0) (Kehoe Absent) G Overview and possible action regarding the review of the grant cycle timeline, the Policy, Guidelines, Application, Evaluation and Recommendation Process for the FY 2022-23 Strategic Partnerships for Community Services Grant Cycle--Shirley J. Rinn, Board Liaison Rinn provided an overview of the history of the Strategic Partnerships for Community Services grant program. There was additional discussion regarding placing an item on a future agenda regarding bias and advisory board member experiences, and how they play a role in determining funding recommendations for the agencies who apply for the grants. There was also an extended discussion regarding the grant application itself and whether or not it is successful in providing the specific information the advisory board is looking for to make those recommendations. There was discussion regarding whether or not there was a directive from the City Council to fund all of the agencies who apply or how much they would get. Rinn told the advisory board that there was not a directive from the City Council to fund all of the agencies. She told them that the minimum grant was $10,000 and the maximum is $50,000. Rinn also clarified that the grant funds can be used for operational costs as well as programming. There was also a brief discussion regarding the funding parameters in our current policy and how they were determined. There was additional discussion regarding the number of agencies that apply and that it was up to the agencies to determine whether or not their agencies meet the funding criteria and whether or they should apply for a grant or not. There was also clarification of the reporting criteria for financials based on the size of the organization. There was discussion regarding the operational expenses being part of the program. There was also clarification that the advisory board has recommended in the past that the funding the agencies received be used for a different purpose than what they applied for. The advisory board also discussed some of the parameters and/or restrictions that have been put in place regarding the funding over the years, as well as the process for implementing them. Rinn told the advisory board that the city organization has implemented a process improvement program for all employee to look at their workload and programs to see if there are ways to improve that process. She told the advisory board that she is working with the City’s Organizational & Operations Excellence (OOE) Team to review the current process and make improvements. She told Page 12 of 143 the advisory board that she would also like to include them as well as members of the non-profit group in our community for their input as well. She also told them that all of the items that were just discussed regarding the grant application form were items that could be addressed during this process. She told them that we will be having a brainstorming workshop with the advisory board and other stakeholders on April 5, 2022 with the OOE team to review areas of improvement in the application process in order to streamline the process. Rinn also let the Advisory Board that a workshop with the City Council was scheduled in May to review the history and current criteria utilized for the SPCS Grant Program. She told them that they were more than welcome to attend the Workshop on May 10, 2022. There was additional discussion and clarification regarding the total amount of funding ($400,049) that is available for the FY 2022 grants, as well as the history of how that amount was determined. H Consideration and possible action to set dates and times for FY 2022-23 Partnerships for Community Services Advisory Board Meetings--Shirley J. Rinn, SPCS Advisory Board Liaison There was discussion regarding possible dates to have our next meetings. Rinn will send potential dates to board members to schedule the next meetings. Adjournment Motion by Griffin, second by Huffman to Adjourn. Meeting was Adjourned at 10:53 a.m. ATTEST: Shirley Rinn, SPCS Advisory Board Liaison Alexia Griffin, SPCS Advisory Board Secretary Page 13 of 143 City of Georgetown, Texas Strategic Partnerships for Community Services May 2, 2022 S UB J E C T: Dis cus s ion and pos s ible ac tion regarding possible revisions and/or updates to the C ity of G eorgetown S trategic P artnerships for C ommunity S ervices G rant Applic ation, Logic Model, and P rogram Budget Template for use during the F Y 2022-23 grant cycle--S hirley J. R inn, Board Liais on IT E M S UMMARY: F IN AN C IAL IMPAC T: N/A S UB MIT T E D B Y: S hirley J. R inn, S P C S Advis ory Board Liais on AT TAC H ME N T S: Description Type Grant Application Backup Material Logic Model Backup Material Program Budget Template Backup Material City of San Marcos Backup Material City of Hutto Backup Material Seeds of Strength Backup Material City of Flower Mound Backup Material City of Round Rock Backup Material City of Bas trop Cover Memo Page 14 of 143 FY2021-22 CITY OF GEORGETOWN STRATEGIC PARTNERSHIPS FOR COMMUNITY SERVICES GRANT APPLICATION City of Georgetown Checklist of Attachments and Signature Page Email the completed Application with required attachments to shirley.rinn@georgetown.org , mail to City of Georgetown, Attn: Strategic Partnerships for Community Services, P.O. Box 409, Georgetown, Texas 78627, or hand deliver to City Hall, 808 Martin Luther King, Jr. St., Georgetown, Texas 78626. The deadline to submit the completed Application is NO LATER THAN JUNE 12, 2021, by 5:00 PM. Late submissions will be declined without consideration. Signature Authorization and Certification of Information I certify, to the best of my knowledge, that all information included in this proposal is correct. The tax exempt status of this organization is still in effect. If a grant is awarded to this organization, then the proceeds of that grant will not be distributed or used to benefit any organization or individual supporting or engaged in unlawful activities. In compliance with the USA Patriot Act and other counterterrorism laws, I certify that all funds received from City of Georgetown will be used in compliance with all applicable anti- terrorist financing and asset control laws, statutes, and executive orders. __________________________________________________________ ___ _______________________ Signature & Title of Authorized Representative (e.g. Executive Director) Date __ ________________________________________________________ Printed Name and Title REQUIRED ATTACHMENT CHECKLIST Budget Information. Include: Program/Project Budget, including all funding sources and expenditures (Excel template provided); Actual Program/Project Budget for prior fiscal year (if applicable); Proposed Organizational Budget for current fiscal year; Organization budget for prior fiscal year. Previous fiscal year financials in PDF format (if e-mailed). Include: balance sheet; income statement; year-to-date financials (balance sheet and income statement). Logic Model Key Staff list. Include titles, short bio, and length of time employed. Please speak specifically to the staff member(s) who will be directing the program and explain why her/his oversight positions the program for success. Copy of the organization’s current 501(c) (3) IRS Letter of Determination indicating tax-exempt status. (If applicable a copy of your fiscal sponsor’s IRS Letter of Determination). Current Board member list. Specify the percentage of the Board members who make a financial contribution to your organization. Include the following information for each board member:  Position and number of years served  Professional affiliations (name of organization of employment and title)  City and zip code of residence Citations and additional information (if applicable). This attachment may be used to cite any statistics/research, to define key terms and/or acronyms, and may include critical detail about your organization or program(s) not already in the grant (no marketing material, please). If applicable: Collaborative work with Georgetown Independent School District staff and/or students. (Attach District’s Letter of Approval). Most recent IRS Form 990, Form 990-EZ or Form 990-N Most recent independent financial audit including Auditors notes a nd Management Letter. (Both the 990 and audit documents should be the same fiscal year). If no audit is available, please attach a document that explains why to comply with Question 5a. *Do not include additional attachments other than the documents reque sted above. Please read the following statement and check the box certifying that this application is complete according to The City of Georgetown’s requirements. I have reviewed the City of Georgetown’s Strategic Partnerships for Community Services Grant Funding Policies and Guidelines to determine if this grant request meets their criteria for funding. Page 15 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 2 of 16 FY2021-22 CITY OF GEORGETOWN STRATEGIC PARTNERSHIPS FOR COMMUNITY SERVICES GRANT APPLICATION Instructions: Complete City of Georgetown’s Strategic Partnerships for Community Services Grant Application Word template. Email the completed Application with required attachments to shirley.rinn@georgetown.org , mail to City of Georgetown, Attn: Strategic Partnerships for Community Services, P.O. Box 409, Georgetown, Texas 78627, or hand deliver to City Hall, 8 08 Martin Luther King, Jr. St., Georgetown, Texas 78626. The deadline to submit the completed Application is NO LATER THAN JUNE 12, 2021 by 5:00 PM. Late submissions will be declined without consideration. PART I. COVER PAGE Organization Name Date IRS Approved 501(c)(3) Status Organization’s legal name: (as shown on 501(c)(3) IRS Letter) Federal Tax ID # Mailing Address City and zip code Phone Number Website Address Program/Project Name Amount Requested Executive Director: (or top executive) (Please include prefix and title) Phone # Email Address: Main contact(s) for this proposal: (Please include prefix and title) Phone # Email Address: Board President: Phone # Email Address: Program or Project Information Program/Project Name Amount Requested Type of Request: Program or Project Support (check one) Program or Project Aligns with City’s Key Priority Area (check one or more) New program or project Existing program or project Expansion of an existing program or project New Collaboration Public Safety Transportation Housing Parks & Recreation Veteran Services Safety Net Program/Project Summary: 100 words or less summarize main objectives and anticipated results (one paragraph) # Current population served by organization (unduplicated individuals and geographic area(s) – cities, counties, etc.) (Unduplicated individuals and geographic areas(s) –cities, counties, etc.) # Target population served through this proposed program request in Georgetown (unduplicated individuals and geographic area(s) – cities, counties, etc.) Page 16 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 3 of 16 PROGRAM/PROJECT STAFFING: Enter the total number of proposed staff to accomplish the program/project activities. # Full-time staff: # Part-time staff: # Volunteers: Organization’s fiscal year end date: through (i.e. 07/01/2021 through 06/30/2022) Organization’s annual budget: $ Total program/project budget: $ Type of Funding Request: (check all that apply) General Operating Support Other (explain) How did your organization hear about the City of Georgetown’s Strategic Partnerships for Community Services Grant Program? Page 17 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 4 of 16 1. ABOUT YOUR ORGANIZATION 1a. Organization Mission Character Limit: 500 1b. Organization Vision Character Limit: 1000 1c. Date of Incorporation Character Limit: 10 1d. Describe your organization's scope of work Character Limit: 2500 1e. Describe your organization's target population Character Limit: 1000 1f. How many unique individuals did your organization serve during the prior fiscal year? Character Limit: 100 1g. What geographic area does your organization serve? Character Limit: 500 1h. What is the purpose of this funding request? Provide enough detail about the program or project so that someone who is not familiar with it can understand what you hope to do, why it is needed and how it will impact your targeted population. Does the program or project address an emerging need or a critical community issue? If so, describe the need and explain how the program or project seeks to address the need. Describe the location of services, and length of services. Character Limit: 2500 1i. Who will your program or project serve? Please describe the program or project’s target population, including age, gender, and socioeconomic group it intends to impa ct. What geographic area will be served? How many Georgetown individuals will be served by the program/project? Character Limit: 500 Page 18 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 5 of 16 1j. How does your program or project intend to achieve the above? How will you know if you are successful? Specifically what and or who will you measure or assess to achieve your program goa ls and objectives? Character Limit: 500 1k. What Organizations will collaborate with you on the program or project? Please list any partners or collaborators and describe the specific role of each. (i.e., agencies, businesses, schools, gover nment entities and others). How does working with these partners/collaborators affect the success of this project/program? Character Limit: 1000 1l. How does the program or project intend to expend the grant? How will The City of Georgetown’s money be spent (description of amounts, e.g. Salary & Benefits $15,000 ; horses)? Provide a brief list of major budget items. Briefly, why do you propose these particular expenditures? Character Limit: 1000 Page 19 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 6 of 16 2. COMMITMENT TO GEORGETOWN 2a. Is your organization's main office located in Georgetown? Choices Yes No If no, where is your organization's main office located? Do you maintain a satellite office in Georgetown? What is the address of the Georgetown-based satellite office? Character Limit: 1000 2b. What year did your organization start serving Georgetown? Character Limit: 10 2c. Describe your organization's work in Georgetown Character Limit: 1500 2d. How many unique Georgetown residents did your organization serve during the prior fiscal year? Out of the total number of unique individuals your organization served during the prior fiscal year (see Question 1f), how many Georgetown citizens did your organization serve? Character Limit: 10 2e. Please select the Georgetown (City limits, ETJ and immediate surrounding area) zip codes your organization serves Choices 78626 78628 78633 78673 78674 76537 76527 Page 20 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 7 of 16 3. FUNDING REQUEST 3a. Please describe how SPCS grant funds will be used, if awarded. Character Limit: 1000 3b. Alignment with City of Georgetown’s Strategic Partnerships for Community Services Grant Funding Policies and Guidelines, and Target Population Describe how your organization and this funding request aligns with the City of Georgetown’s Key Priority Areas (Cover Page Part I) and your organization’s Target Population. Specifically identify the target population with which you will be working. Character Limit: 3000 4. PRIOR RELATIONSHIP WITH CITY OF GEORGETOWN 4a. Has your organization ever received a City of Georgetown grant, sponsorship, or other financial or in-kind support? Choices Yes No If yes, please list years, amounts, and type of funding (grant, sponsorship, other financial support) your organization has received from City of Georgetown. Character Limit: 1000 4b. Do you currently receive a rent or other in-kind subsidy from the City of Georgetown? Choices Yes No If yes, include the location/address of the property and the current monthly rent per your lease agreement and/or the total and type of in-kind support received from the City of Georgetown. Character Limit: 250 Page 21 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 8 of 16 5. FINANCIAL OVERVIEW 5a. Most Recent Audit. If your organization is applying for more than $25,000, include all formal communication received from the audit firm in relation to the audited financial statement. If your organization is applying for less than $25,000 and if your organization has not commissioned a financial audit, the city will accept a CPA prepared financial statement review. If you are applying for less than $15,000 and if your organization has not commissioned a financial audit or does not have a CPA prepared financial statement review, the City will accept a compilation of the organization’s financials, which is when a CPA takes financial data provided by your organization and puts them in a financial statement format that complies with generally accepted accounting principles, with no further review. 6. ORGANIZATIONAL STRATEGY & CAPACITY1 Remember to answer Questions 6a-6e at the organizational level, not the program level. Be sure to cite all statistics and research in a separate document. 6a. What is your organization striving to accomplish? Clearly and concisely state your organization's ultimate goal for intended impact. Identify the groups or communities you aim to assist, the needs your work is addressing, and your expected outcomes. Examine how your goals for the next three to five years (or an alternate time frame specified in your answer) fit within your overall plan to contribute to lasting, meaningful change. When finished ask yourself, "If someone unfamiliar with our work were to read this, would they have a clear definition of what long-term success means for my organization?" Character Limit: 2000 6b. What are strategies for making this happen? Describe your organization's strategies for accomplishing the long -term goals you cited in 6a. Specify the broad approaches you employ and why your organization believes these methods will benefit your target population or advance your issue. State near-term activities that serve as important building blocks for future success, explaining how these elements strengthen your organization's strategic approach. Character Limit: 2000 1 The questions in this section (6a-6h) were adopted from Charting Impact, developed by the Better Business Bureau Wise Giving Alliance, GuideStar USA, and Independent Sector. We chose to use these five questions because they have been thoroughly tested and encourage strategic thinking Page 22 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 9 of 16 6c. What are your organization's capabilities for doing this? Detail the resources, capacities, and connections that support your progress t oward long-term goals cited in 6a. While describing your organization's core assets, identify both internal resources (including, but not limited to, staff, budget, and expertise) and external strengths (including partnerships, collaborations, networks, and influence) that have contributed to, or will contribute in the future to, the accomplishment of these goals. Character Limit: 2000 6d. How will your organization know if you are making progress? Explain how your organization assesses progress toward your intended impact cited in 6a. Identify milestones that signal progress and success. Describe your assessment and improvement process: the methods you use as you monitor key indicators and how your organization uses that information to refine your efforts. Character Limit: 2000 6e. What have and haven't you accomplished so far? Demonstrate recent progress toward your long-term goals cited in 6a. by describing how your near- term objectives are propelling your organization toward your ultimate intended impact. Go beyond the outputs of your work to make clear how these outcomes are contributing to fulfilling long-term goals. In describing both outcomes achieved and those not yet realized, include what your organi zation has learned about what does and doesn't work, what risks and obstacles exist, and what adjustments to goals, strategies, or objectives have been made along the way. Character Limit: 2000 6f. Key Staff List Include titles, short bio, and length of time employed. Please speak specifically to the staff member(s) who will be directing the proposed work and explain why her/his oversight positions the work or success. the way. Character Limit: 1000 6g. Board List List individual board member’s name, place of business, home address, and years with the organization. Specify the percentage of board members that make a financial contribution to your organization. 6h. 501(C)3 IRS Determination Letter Page 23 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 10 of 16 7. PROPOSED PROGRAM DETAILS 7a. Description of Proposed Program If proposed Program is the same as and incorporates overall Organizational mission, strategy and goal, please make that notation and refer to responses in Section 6. If the Program request is different, please be specific about how you intend to utilize the requested grant funds for your proposed program. (i.e. if you need office supplies, training for volunteers, horses, etc., be specific). Describe the program for which you are requesting funding and the issue it seeks to address. Detail the strategies, resources, capacities, and connections that support your progress toward the program's identified goals. Provide evidence to support the strategies you employ within the program that reinforce your organization's long-term goals, and whether such strategies have been proven by research. Character Limit: 2000 7b. How does this program or project contribute to your organization’s overall mission? What is the specific unmet need(s) you are seeking to address? What activities will your program impleme nt to address this need? Is this a new, or an expansion of an ongoing program? If this is an existing program, provide service statistics and how it was previously funded. Describe your target population and how many individuals will be impacted during the grant period. What percentage of individuals served will be Georgetown residents? Character Limit: 2000 7c. Proposed Impact What does your program or project hope to accomplish ? (Outputs and/or Outcomes) Describe your program or project’s overall goals and objectives. Where will the activities t ake place? How will this program or project transform your organization and how will it transform the lives of the target population? Character Limit: 2000 7d. Do you have data that supports your proposal with existing research or agency experience. If yes, please provide statistics about the local area if possible. Describe to what extent to whic h your program/organization is based on evidence-based, best, or best practice. Is the program based on another program/project that has been shown to be effective in other settings? Character Limit: 2000 7e. Please provide the names of other agencies that provide similar, overlapping, or duplicate services as your organization. Please describe those services, particularly as to how those services are similar to, overlap, or duplicate the program or project you plan to accomplish with this grant request . Character Limit: 1000 Page 24 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 11 of 16 7f. Provide program service costs in the table below and describe how you arrived at your service cost. (Enter the mathematical calculations in the table below that resulted in the individual/unit service cost). Program Service Costs (Note: Table below will expand should you need to include additional comments/clarifications.) Proposed Total Number of Unduplicated Individuals Served Total Program Costs Cost Per Unduplicated Individual 7g. Does this program provide opportunities for matching or incentive funds within your organization or from other grantees? Character Limit: 500 7h. What staff, board, or volunteer training and professional development needs are required to implement this program or project, if any? Please be specific. If not, how does the organization provide the initial, annual and on-going training to your Board members, program staff and volunteers? (e.g., trainings on cultural competency, effective use of social media, or fundraising techniques). Character Limit: 1000 7i. Identify collaborating partners for the program or project and describe their role and expertise. Due to space limitations, describe the interactions that are most important to the program in terms of helping it achieve its goals. (Limited to bullet points). 7j. What is the timeline for implementing this grant? Please include the program or project’s major events, activities and where and when they will take place. (Limit to bullet points and chronological order). 7k. If your proposed program or project is ongoing, please explain how you will continue to deliver benefits to the target population after the grant period has ended. What is your Board’s role in ensuring the continuation of the program? If the project is not ongoing, please explain how you will responsibly bring the project to an end. Character Limit: 1000 7l. How do you determine the Georgetown community's need for this program? Character Limit: 2000 Page 25 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 12 of 16 7m. Provide Budget for Proposed Program Provide the budget for your proposed program using the Excel template provided. 7n. Provide Actual Program Budget for Prior Fiscal Year 7o. Does this program provide opportunities for matching or incentive funds within your organization or from other grantees? Character Limit: 500 8. GOALS Grant Period: The grant period for all City of Georgetown’s Annual Grants is October 1, 2021 – September 30, 2022. 8a. Number of Georgetown Residents to be Served by this Grant. Character Limit: 6 8b. GOALS & LOGIC MODEL Define the primary goal you hope to achieve through this funding for your program. The goal should be attainable within a 12-month period, and must relate to goals/outcomes articulated in the Program request section of this proposal. To complete the table below you must first complete the required City of Georgetown’s Program/Project Logic Model Template (Please see www.georgetown.org to review additional information on the Program Logic Model, and Glossary in preparation for how to complete the Logic Model Attachment.) Enter the information from your completed Program Logic Model into the Target Population, Outcomes and Performance Measures table below. Please add additional pages if necessary GOAL: (Note: Table below will expand should you need to include additional information) Target Population (Describe individuals who will benefit from the program and how many will be served during the 12 month grant period) Number served during the grant period: Outcomes/Results (Written as change statements) Performance Measures (What and how will you measure and quantify the programs results?) Page 26 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 13 of 16 GOAL: Target Population (Describe individuals who will benefit from the program and how many will be served during the 12 month grant period) Number served during the grant period: Outcomes/Results (Written as change statements) Performance Measures (What and how will you measure and quantify the programs results?) GOAL: Target Population (Describe individuals who will benefit from the program and how many will be served during the 12 month grant period) Number served during the grant period: Outcomes/Results (Written as change statements) Performance Measures (What and how will you measure and quantify the programs results?) 8c. How will the evaluation results be used to inform/strengthen future programming and organizational operations? Character Limit: 2000 Page 27 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 14 of 16 9. ORGANIZATIONAL FINANCIALS 9a. Fiscal Year Start Date Please enter the start date of your current fiscal year Character Limit: 10 9b. Fiscal Year End Date Please enter the end date of your current fiscal year. Character Limit: 10 9c. What are your organization's cash reserves, i.e., days cash on hand? Character Limit: 20 9d. How many months could the organization operate at your continued budget level? Character Limit: 10 9e. Balance Sheet for Prior Fiscal Year 9f. Income Statement for Prior Fiscal Year 9g. Actual vs. Budget Income Statement for the Prior Fiscal Year 9h. Current Year-to-Date Financials to include Balance Sheet and Income Statement. 9i What percentage of your budget is for Administration and what percentage is used to provide Services for your target population? Administration is defined as general and administrative expenses (G&A). 9j. Year-to-Date Cash Flow Statement. What are your cash reserves? How many months could you operate at your continued budget level? If your organization generates a Cash Flow statement, please provide, If not, leave blank. 9k. Organization Budget for Proposed Fiscal Year, Related to the Grant Period Page 28 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 15 of 16 9l. Sources of Organizational Support-Previous and Current Fiscal Year (The purpose of this section is to provide an overview of your organization’s revenue streams for the previous fiscal year en d and current year-to-date). Instructions: List all funding sources for both years. For the current FY enter the dollar amount of funding to date. Indicate whether the funds are pending (P), or in-hand (I). Examples: $5,000 (P), $10,000 (I) Previous Fiscal Year End Dates: _________ to _________ Current Fiscal Year End Dates:________to ___________ External Sources Name(s) of Funders(s) Amount Previous Fiscal Year Name(s) Funder(s) Amount Current Fiscal Year Foundation Grants Individual Contributions N/A – no need to disclose the name of individual donors N/A- no need to disclose the name of individual donors Corporate Foundations Government Grants Fundraising Events (net) Other Specify Describe: Internal Sources Program Service Revenue Membership Income Investment Income Other Specify Describe TOTAL REVENUES TOTAL REVENUES Page 29 of 143 City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application Page 16 of 16 Please list all funding sources receiving this program request. Enter the name of the funder, amount and date the funds were requested and the current funding status of the request. Funding status examples: Funded, Pending, or Committed. Please add extra sheets if necessary. Funding Sources Receiving this Program or Project Request Name of Funder Amount requested Date Requested Funding Status 9k. Most Recent Organization Audit See Q5a for financial reporting parameters. 10. CITATIONS, ACKNOWLEDGEMENT & ASSURANCE 10a. Citations and Additional Information (optional) This attachment may be used to cite any statistics/research, to define key terms and/or acronyms, and may include critical details about your organization or program(s) not already included within this application that will strengthen your case for funding (no marketing material, please). File Size Limit: 2 MB 10b. Acknowledging the City of Georgetown Type your name and date in the space below to assure that if funded, the organization will acknowledge the City of Georgetown on all related marketing materials, your website, social media, and in any other communications in which this program is promoted. Character Limit: 50 10c. Assurance Type your name and date in the space provided to assure that by submitting this application, you 1) confirm that the information herein is true and correct, 2) confirm that if funded, funds will be spent according to the budget listed in this application, and 3) confirm that the organization will submit interim and final reports as required. Character Limit: 50 THANK YOU for your time and effort in completing these forms! Page 30 of 143 CITY OF GEORGETOWN FY2022-23 LOGIC MODEL TEMPLATE Guidelines for Completing the Program Logic Model Attachment A Logic Model is a valuable tool for organizational planning, implementation, funding and quality improvement. The model demonstrates to funders that you have purposefully identified what your program will do, what it hopes to achieve, and what resources you will need to accomplish your work. This outline is intended to guide you in using the City Of Georgetown Logic Model Template. The seven components included in the model are outlined below in the order they should be considered when planning a program. Logic Model Components Goal(s): Serve as a frame for all elements of the logic model that follow. They include intended results of the program and specify t he target population you intend to serve. Program Planned Work Intended Result Performance Measures: The process of deciding what to evaluate, collecting information, analyzing that information and reporting it. Who is collecting the data, at what intervals, and shared with whom? How do you record the effectiveness of your program? Writing Your Logic Model 1. Goal(s): Use a one-sentence overview of what the program is designed to accomplish and specify the target population you intend to serve. 2. Target Population: The people you serve. Identify enough information to help the grant reader understand who will be nefit from your program. Characteristics: Age range, gender, ethnicity, educational level, or income level. Communities served: Cities, zip codes, or county. Make sure it falls within the funding parameters. 3. Inputs are resources, or investments needed by the program to provide services. Common types of resources include: Human: full and part -time staff, consultants, volunteers. Financial: grants or contributions. Space: Office and other facilities or technology, equipment and materials. 4. Activities are the action steps that are needed to implement your program – what you will do with the program resources in order to achieve program outcomes and ultimately, your goal(s). Activities are: Providing services (e.g., education and training) and developi ng products (e.g., educational curricula). Who is the key person(s) responsible to achieve the objectives and can it be done on time? Each activity needs a completion date. 5. Outputs are measurable, tangible, and direct products or results of program activities. Outputs lead to the desired outcomes – benefits for participants, families or communities – but are not themselves the changes you expect the program to produce. They do help you assess how well you are implementing the program. Examples of program outputs include numbers and descriptions of: # individuals who completed training programs, # hours of service provided, # focus groups held, # of classes offered, # units of service, and # service hours provided. 6. Outcomes express the results that your program intends to achieve if implemented as planned. Outcomes are the changes that occur or the difference that is mad e for individuals, groups, families or organizations. Outcomes answer the questions: “What difference does the program make? Wha t does success look like?” They reflect the core achievements you hope for your program. Organizations with diverse missions and services share common categories of outcomes, because outcomes are about change: changes in learning, changes in action, or changes in condition. Changes in learning: (e.g., new knowledge, increased skills, and changed attitudes). Changes in action: (e.g., modified behavior or practice, changed decisions). Changes in condition: Human (e.g., from oppression to freedom; from malnourishment to food security), Economic (e.g., from unemployment to employed), Civic (e.g., from disenfranchised to empowered, and Environme ntal (e.g., from polluted to clean). 7. Performance Measures is the process of deciding what to evaluate, collecting information, analyzing that information and reporting it. Who is collecting and reviewing the data, at what intervals and shared with whom? How you record the quality and effectiveness of your program. Examples: a ttendance records, number of attendees, pre-test to post-test results and surveys. Target Population Who we reach: Customers Inputs Resources What we invest: Activities with a timeline What we will do: Outputs How we measure effort Outcomes Results How we measure effect Page 31 of 143 CITY OF GEORGETOWN FY2022-23 LOGIC MODEL Program Logic Model Example and Instructions The completed logic model below provides an example from which you can pattern your proposed Program’s Logic Model. We have attached the Logic Model template with this example for you to complete and submit with your Grant Application. The time period for the grant is 12 months. Complete at least one goal for your Program. If you have more than one goal, please complete the second goal. The expected outcomes should reflect clear, reasonable and measurable statements. After you have completed the Program Logic Model, you are ready to complete the Grant Application SECTION E: Question 11. EVALUATION- PROGRAM LOGIC MODEL by entering the information from your Logic Model into the EVALUATION Table: Program goal(s), target population description, numbers to be served, outcomes, and performance measures. When you have completed your Logic Model, print out the page(s) and scan to a pdf.file. The file name should begin with your organization’s name followed by a hyphen and identified as : “Org Name-Staff & Logic Model,” and submitted with your Application. Organization: ABC Nonprofit Program Name: Computer Training Time Period: October 1, 2022 – September 30, 2023 Program/Project Goal: Provide computer training for workplace therapists to increase workload capacity. Target Population Who we reach Inputs Resources What we invest Activities - Action Steps & Timeline What we will do to achieve the goal Outputs How we measure effort Outcomes How we measure effect and written as change statements 25 ABC workplace therapists with underdeveloped computer skills who reside in Georgetown Texas $12,000 purchase and installation of 25 computer workstations including software $10,000 XYZ company computer contractor expense for one year. Computer trainer hired to provide computer training for workplace therapists. Obtain bids for 25 computers- July 2021 Computers installation date- Sept 31, 2021 XYZ computer trainer signed one year training contract – Sept 2021 Contract trainer modified ABC computer storage procedures for electronic data transfer to ABC Training Manual- Sept 2021 25 workplace therapists receive computer training from XYZ computer contractor to upgrade their computer skills–Sept-Oct 2021 Computer trained workplace therapists transfer data to electronic storage data – Nov-Dec 31, 2021* 25 computers purchased and installed The ABC Computer Training Manual is revised to include procedures of how to transfer data to electronic storage data. 25 workplace therapists complete pre and post testing of computer skills. 25 workplace therapists’ data was entered and transferred to electronic storage 25 or 100% of workplace therapists demonstrate successful use of computer* Each workplace therapist increased the number of their clients by 20%. Current clients =20 (July 2021) Clients post training= 24 (June 2022*) Therapists travel time is decreased by 35% as reflected on time records June, 2022* *Put a “*”next to those you will measure Performance Measures: Workplace therapist’s pre and post computer testing. Computer data storage report Dec 31, 2021. Workplace therapists time records. Comparison of prior year number of clients served and number of clients seen as of June 2022 after therapists completed computer training. Workplace training data was reviewed by XYZ computer contractor and report sent to ABC Branch Manager for review, and management distribution. Page 32 of 143 CITY OF GEORGETOWN FY2021-22 LOGIC MODEL TEMPLATE The blank logic model template provided below is to be used by grant applicants to identify all sections of the model. If selected for funding, grant recipients are required to report on the progress of their planned outcomes during the program period. (See logic model example provided with this attachment). To enter data, position the cursor in each box where you want the data entered, click and begin typing your answer. The table will expand as you type. Please type your responses directly into the form. After you have completed the Program Logic Model, you are ready to complete the Grant Application SECTION E: Question 11. EVALUATON-PROGRAM LOGIC MODEL by entering the information from your logic model into the Grant Application EVALUATION Table: Program goal(s), target population description, numbers to be served, outcomes, and performance measures. After completing the template, print out this page(s) and scan to a pdf. file. The file name should begin with your organization’s na me followed by a hyphen and identified as: “Org Name-Staff & Logic Model,” and submitted with your Grant Application. Organization: Program/Project: Time Period: Program/Project Goal: Target Population Inputs Resources Activities - Action Steps & Timeline Outputs Outcomes *Put a “*” next to those you will measure Performance Measures: Program/Project Goal: Target Population Inputs Resources Activities - Action Steps & Timeline Outputs Outcomes *Put a “*” next to those you will measure Performance Measures: Page 33 of 143 Program Budget City of Georgetown Grant Application for FY 2022-23 This format is required. Please enter your information into the shaded cells for rows applicable to the program for which you are requesting funding. Use the column titled "Detail for this Grant Request" to show specifically how our grant will be used in your Program Budget. If needed, there is space at the bottom to include narrative explaining your numbers & assumptions. Name of Organization: Budget Period From:10/2/2022 To:9/30/2023 Total Program or Detail for this Revenue/Support for this Program or Project Project Budget Grant Request Individual contributions -$ -$ Fundraisers & Special Events -$ -$ Program/Service Revenues -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ Total Revenue/Support (calculated for you or enter your own total)-$ -$ Expenses for this Program or Project Total Amount Grant Request Salaries, benefits and related taxes -$ -$ Consultants and professional fees -$ -$ Professional development including travel, lodging -$ -$ Equipment -$ -$ Supplies and supporting materials -$ -$ Printing, copying, phone, internet, fax, postage -$ -$ Mortgage or Rent, and Utilities -$ -$ Fundraising Expenses -$ -$ Other (list below and describe in narrative/notes if more space is needed) -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ Total Expense (calculated for you or enter your own total)-$ -$ Difference (Revenue/Support less Expense)-$ -$ Narrative/Notes: Please use as many lines as needed for further explanation of budget items above. 1 2 3 4 Government, Foundation, Corporate Grants or Other (list below; describe in narrative/notes if more space is needed) Page 1 of 2 Page 34 of 143 Program Budget City of Georgetown Grant Application for 2021-2022 This format is required. Please enter your information into the shaded cells for rows applicable to your program/project. Use the "Other" sections to provide data for other types of revenue or expense in your program or project budget. Show specifically how our grant is used. Include narrative at the bottom to explain your numbers & assumptions, as needed. Name of Organization: Budget Period From:10/1/2021 To:9/30/2022 Total Program or Detail for this Revenue/Support for this Program or Project Project Budget Grant Request Individual contributions -$ -$ Fundraisers & Special Events 1,000.00$ -$ Program/Service Revenues 10,000.00$ -$ Foundation Grants 25,000.00$ 15,000.00$ City of Anytown 5,000.00$ -$ XYZ Corporation 8,000.00$ -$ Member Dues 1,000.00$ -$ -$ -$ -$ -$ -$ -$ Total Revenue/Support (calculated for you or enter your own total)50,000.00$ 15,000.00$ Expenses for this Program or Project Total Amount Grant Request Salaries, benefits and related taxes 19,000.00$ 5,000.00$ Consultants and professional fees -$ -$ Professional development including travel, lodging 500.00$ -$ Equipment -$ -$ Supplies and supporting materials 200.00$ -$ Printing, copying, phone, internet, fax, postage 200.00$ -$ Mortgage or Rent, and Utilities -$ -$ Fundraising Expenses -$ -$ Other (list below and describe in narrative/notes if more space is needed) General Liability Insurance 100.00$ -$ Scholarships 30,000.00$ 10,000.00$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ Total Expense (calculated for you or enter your own total)50,000.00$ 15,000.00$ Difference (Revenue/Support less Expense)-$ -$ Narrative/Notes: Please use as many lines as needed for further explanation of budget items above. 1 Applied for $10,000 grant from the X Foundation. Response due May 1. 2 Salaries for: Part-time coordinator $9,000; Part-time instructor $10,000 3 4 ABC Organization Government, Foundation, Corporate Grants or Other (list below; describe in narrative/notes if more space is needed) Page 2 of 2 Page 35 of 143 Page 36 of 143 Page 37 of 143 Page 38 of 143 Page 39 of 143 Page 40 of 143 Page 41 of 143 Page 42 of 143 Page 43 of 143 Page 44 of 143 Page 45 of 143 Page 46 of 143 Page 47 of 143 Page 48 of 143 Page 49 of 143 Page 50 of 143 Page 51 of 143 Page 52 of 143 Page 53 of 143 Page 54 of 143 Page 55 of 143 Page 56 of 143 Page 57 of 143 Page 58 of 143 Page 59 of 143 Page 60 of 143 Page 61 of 143 Page 62 of 143 Page 63 of 143 Page 64 of 143 Page 65 of 143 Page 66 of 143 Page 67 of 143 Page 68 of 143 Page 69 of 143 Page 70 of 143 Page 71 of 143 Page 72 of 143 Page 73 of 143 Page 74 of 143 Page 75 of 143 Page 76 of 143 Page 77 of 143 Page 78 of 143 Page 79 of 143 Page 80 of 143 Page 81 of 143 Page 82 of 143 Page 83 of 143 Page 84 of 143 Page 85 of 143 Page 86 of 143 Page 87 of 143 Page 88 of 143 Page 89 of 143 Page 90 of 143 Page 91 of 143 Page 92 of 143 Page 93 of 143 Page 94 of 143 Page 95 of 143 Page 96 of 143 Page 97 of 143 Page 98 of 143 Page 99 of 143 Page 100 of 143 Page 101 of 143 Page 102 of 143 Page 103 of 143 Page 104 of 143 Page 105 of 143 Page 106 of 143 Page 107 of 143 Page 108 of 143 Page 109 of 143 Page 110 of 143 Page 111 of 143 Page 112 of 143 Page 113 of 143 Page 114 of 143 Page 115 of 143 Page 116 of 143 Page 117 of 143 Page 118 of 143 Page 119 of 143 Page 120 of 143 Page 121 of 143 Page 122 of 143 Page 123 of 143 Page 124 of 143 Page 125 of 143 Page 126 of 143 Page 127 of 143 Page 128 of 143 Page 129 of 143 Page 130 of 143 Page 131 of 143 Page 132 of 143 Page 133 of 143 Page 134 of 143 Page 135 of 143 Page 136 of 143 Page 137 of 143 Page 138 of 143 Page 139 of 143 Page 140 of 143 Page 141 of 143 Page 142 of 143 Page 143 of 143