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
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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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?)
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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City of Georgetown Strategic Partnerships for Community Services 2021-22 Grant Application
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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
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