HomeMy WebLinkAboutAgenda_SPCS_07.24.2018Notice of Meeting for the
Strategic Partnerships for Community Serv ices Adv isory Board
of the City of Georgetown
July 24, 2018 at 9:00 AM
at City Hall Main Floor Conference Room, 113 E. 8th Street, Georgetown, Texas 78626
The City o f G eo rgeto wn is committed to comp lianc e with the Americans with Dis abilities Ac t (ADA). If yo u
req uire as s is tanc e in participating at a p ublic meeting d ue to a disability, as d efined und er the ADA, reas onab le
as s is tance, ad ap tatio ns , or acc o mmo d ations will b e provid ed up o n req uest. P leas e c o ntact the City Sec retary's
Office, at leas t three (3) days prior to the sc hed uled meeting d ate, at (512) 930-3652 o r City Hall at 113 Eas t 8th
Street fo r add itional info rmation; TTY us ers ro ute through Relay Texas at 711.
Regular Session
(This Regular S es s io n may, at any time, b e rec es s ed to convene an Exec utive S es s io n fo r any p urpose
authorized b y the Op en Meetings Act, Texas Go vernment Co d e 551.)
A Call to Ord er--Jaquita Wilson, SPCS Advis ory Board Chair
B Ro ll Call --Jaquita Wilson, SP CS Advis ory Board Chair
C Co nsideration and possible actio n to approve the Minutes fro m the June 18, 2018 SP CS Advis o ry Board
Meeting—Alexia Griffin, Sec retary
D Dis cus s ion and pos s ible actio n regarding the allo catio n recommend ations to b e made to the City Co unc il
for fund ing o f the Strategic Partnership s fo r C o mmunity S ervic es (SPCS ) Grants fo r F Y 2018-19—
Jaq uita Wils on, SP CS Advis o ry Bo ard Chair
E Dis cus s ion, review, and possible actio n regard ing of the Williams o n Co unty F und ers ' Co mmo n Grant
Ap p lication, City o f Georgetown Program Ad d endum, Program Bud get and Evaluatio n Tool fo r the C ity
of Geo rgetown — Jaquita Wilson, SPCS Ad vis ory Board Chair
F Ad jo urn
CERTIFICATE OF POSTING
I, Shelley No wling, C ity S ecretary fo r the C ity of Geo rgeto wn, Texas , d o hereby c ertify that this Notice of
Meeting was p o s ted at City Hall, 113 E. 8th Street, a p lace read ily acc es s ible to the general p ublic at all times ,
on the ______ d ay o f __________________, 2018, at __________, and remained so p o s ted fo r at leas t 72
c o ntinuo us ho urs p receding the sc heduled time o f s aid meeting.
____________________________________
S helley No wling, City Sec retary
Page 1 of 19
City of Georgetown, Texas
Strategic Partnerships for Community Services
July 24, 2018
SUBJECT:
Cons id eration and p o s s ib le ac tion to approve the Minutes from the June 18, 2018 S PCS Ad visory Board
Meeting—Alexia Griffin, S ecretary
ITEM SUMMARY:
ATTACHMENTS:
1. Draft Minutes for the June 18, 2018 SPCS Ad vis ory Board Meeting.
FINANCIAL IMPACT:
None
SUBMITTED BY:
Shirley J. Rinn fo r Alexia Griffin, SPCS Advis ory Board Chair
ATTACHMENTS:
Description Type
DRAFT Minutes Backup Material
Page 2 of 19
SPCS Advisory Board Minutes
June 18, 2018
Page 1 of 2
Minutes of the Meeting of the
Strategic Partnerships for Community Services Advisory Boa rd
City of Georgetown, Texas
June 18, 2018
The Strategic Partnerships for Community Services Advisory Board of the City of Georgetown, Texas, met on
Monday, June 18, 2018 at 5:30 p.m.
Members Present: Jaquita Wilson, Alexia Griffin, Natalia Ornelas, and Jerry Haecker
Members Absent: Michael Douglas
Staff Present: Shirley J. Rinn, Executive Assistant to the City Manager
Guest: Josie Zamora
MINUTES
Legislative Regular Agenda
A. Call to Order—Jaquita Wilson, SPCS Advisory Board Chair
The meeting was called to order at 5:31 p.m.
B. Roll Call --Jaquita Wilson, SPCS Advisory Board Chair
All members except Mike Douglas were present.
C. Consideration and possible action to approve the Minutes from the May 1, 2018 SPCS Advisory Board
Meeting—Alexia Griffin, SPCS Advisory Board Secretary
Motion by Haecker, second by Ornelas to approve the Minutes from the May 1, 2018 SPCS Advisory
Board Meeting. (Approved 4-0) (Douglas Absent)
D. Discussion and possible action regarding the review of A Gift of Time Adult Day Care’s Interim Report
related to its FY 2017-18 Strategic Partnerships for Community Services grant award and possible
recommendations for the City Council’s consideration—Shirley Rinn, Staff Liaison to the SPCS Advisory
Board
Rinn provided a quick overview of this item and introduced Josie Zamora who is the Executive Director of
A Gift of Time Adult Day Care. Zamora provided a report of the Agency’s progress in finding a facility to
provide the adult day care services and the challenges it has faced in finalizing that effort. She told the
SPCS Advisory Board that the initial disbursement of the SPCS grant funds in the amount of $8,500 that
the Agency received in October 2017 is currently being held in a special account until the building is
secured. Once the building is secured, the Agency still plans to utilize all of the grant funds ($17,000) it
was awarded to complete the purchase of the Amazing Place Dementia Day Program (APDP) and to
provide training for the staff hired to operate the facility. She also told the SPCS Advisory Board that the
Agency is also prepared to return the funding to the City should the City Council determine that they need
to do that.
Page 3 of 19
SPCS Advisory Board Minutes
June 18, 2018
Page 2 of 2
The SPCS Advisory Board determined that the Agency has made significant progress toward its goals and
will make a recommendation that the City Council approve the disbursement of the remaining balance of
the FY 2017-18 SPCS Grant Award to A Gift of Time Adult Day Care in the amount of $8,500.
Motion by Haecker, second by Wilson to recommend to the City Council that it approve the disbursement
of the remaining balance of the FY 2017-18 SPCS Grant Award to A Gift of Time Adult Day Care in the
amount of $8,500 prior to the end of the current fiscal year. (Approved 4-0) (Douglas Absent)
E. Adjourn
Motion by Wilson, second by Haecker to adjourn.
Meeting was adjourned at 6:00 p.m.
Attest:
Alexia Griffin, Board Secretary Jaquita Wilson, Board Chair
Page 4 of 19
City of Georgetown, Texas
Strategic Partnerships for Community Services
July 24, 2018
SUBJECT:
Disc ussion and p o s s ib le ac tion regard ing the alloc ation rec o mmendatio ns to be mad e to the City Counc il
fo r funding of the S trategic P artners hips fo r Community Services (SPCS) G rants for FY 2018-19—Jaq uita
Wilson, SPCS Ad vis ory Board Chair
ITEM SUMMARY:
The Strategic P artners hips to r Community Servic es Advis o ry Board Memb ers were provid ed copies of the
grant applic ations that were received b y the City for the F Y 2018-19 Grant Cycle, a copy o f the Grant
Funding Polic y and Guidelines for FY 2018-19, and an Evaluation To o l for each grant applic ation for the
Bo ard Members to review and analyze in preparation fo r the gro up d is cus s io n and delib eration regard ing
final allo cation rec o mmendatio ns to the City Counc il.
As p art o f the review and d is cus s io n, eac h Board Memb er will disc lo s e any c o nflic ts o f interests they may
have with regard to any of the agenc ies that ap p lied for fund ing.
FINANCIAL IMPACT:
The Funding for Strategic Partnership s for C o mmunity S ervic es is allo cated in the proposed FY 2018-19
Budget.
SUBMITTED BY:
Shirley J. Rinn fo r Jaq uita Wils o n, SPCS Advis o ry Bo ard Chair
Page 5 of 19
City of Georgetown, Texas
Strategic Partnerships for Community Services
July 24, 2018
SUBJECT:
Disc ussion, review, and p o s s ib le ac tion regarding o f the Williamson Co unty Funders ' Common Grant
Applic ation, C ity of Geo rgeto wn P ro gram Addend um, P ro gram Budget and Evaluation To o l for the City
o f Georgetown — Jaq uita Wils o n, SPCS Advis o ry Bo ard Chair
ITEM SUMMARY:
The Williamso n County Funders Gro up, whic h includ es representatives from the C ity of Geo rgeto wn,
United Way of Williams on Co unty, Seed s of S trength, Georgetown Health F o und ation, Chis holm Trail
Community F o und ation and Greater Ro und Roc k Community Foundatio n, meets o n a regular b as is
d is cus s any is s ues or o b s ervatio ns related to their grant p ro grams, other regio nal is s ues related to their
p ro grams, and als o at least annually to p ro vid e any s uggestio ns o r ideas to enhance the effec tiveness o f the
Common Grant Applic ation that all o f these agenc ies utilize in their grant making p ro cesses.
The Funders gro up recently met on July 18, 2018 and Jaq uita Wils o n and S hirley R inn were in attend anc e.
They wo uld like to s hare with the Ad visory Bo ard the o utcomes o f that meeting and d is cus s any ad d itional
o b s ervatio ns or s ugges tio ns the S trategic Partners hip s for Community Servic es Advis o ry Bo ard may have
related to their review of the applic ations , as well as any o ther sugges tions o r obs ervations they may have
related to the ap p lic atio n materials and the tools utilized for the review and rec o mmendatio n p ro cess fo r the
City o f Georgeto wn’s S PCS Grant Pro gram.
FINANCIAL IMPACT:
N/A
SUBMITTED BY:
Shirley Rinn for Jaquita Wilson, Bo ard Chair
ATTACHMENTS:
Description Type
Williams on County Funders Common Grant Application Backup Material
COG Program Addendum Backup Material
Program Budget Report Template Backup Material
Page 6 of 19
2018 COMMON PROGRAM GRANT APPLICATION
Williamson County Funders
Instructions: Complete and submit this application along with attachments listed below. Refer to individual
funder’s grants processes to determine the deadline to submit this complete application, and to determine
whether certain financial documents are required. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
CHECKLIST OF ATTACHMENTS
(PLEASE SUBMIT WITH APPLICATION)
Addendum (specific to Funder). Funder Name: City of Georgetown
Budget Information. Include:
Program/Project Budget (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.
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.
Board list. Specify the percentage of Board members that make a financial contribution to your
organization. Under each individual Board member’s name, include:
o place of business;
o home address;
o years with the organization.
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 this proposal will fund collaborative work with Georgetown Independent School District
staff and/or students, attach the District’s Letter of Approval of the PIE Partnership Proposal.
501(c)(3) IRS determination letter.
Previous fiscal year financials in PDF format. Include:
balance sheet;
income statement;
year-to-date financials (balance sheet and income statement).
Audited financials and Form 990 (both documents should reflect the same fiscal year). Refer to
specific funder’s requirements.
audited financials;
Form 990;
N/A.
Page 7 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 2 of 10
Key Terms Defined
Please refer to these terms as you respond to requests for information in the Organization Information,
Organization Background, Program Request Information, and Evaluation sections of this application.
MISSION A statement of the overall purpose of an organization – what you
will do every day to make your vision a reality
VISION A picture of the “preferred future;” a statement that describes how
the community’s future will look if the organization achieves its
ultimate aims.
VALUES or GUIDING PRINCIPLES General guidelines which set the foundation for how an organization
will operate and run mission-related activities.
GOALS Broad, long-term aims that define accomplishment of the mission (in
a particular work area).
STRATEGIC DIRECTION The main themes/focuses/areas that will lead the organization
toward accomplishing its MISSION.
STRATEGY A plan/activity required to achieve and OUTCOME.
ACTION STEPS Specific steps to be taken to implement a strategy: who is involved,
what is needed, when this will happen
OUTCOME Specific, attainable, realistic result that shows the accomplishment of
a strategy.
Page 8 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 3 of 10
Organization Information
Organization Name
Legal Name (if different)
Year Founded
Mailing Address
Phone
Website
Federal Tax ID #
CEO or Executive Director (include title
if other than “CEO” or “ED”)
Phone Number & Email Address
Organization Mission
Organization Vision
Total Request Amount
# of Current Population Served by
Organization (unduplicated individuals and
geographic area(s) – cities, counties, etc.)
# of Target Population Served
through this Program Request
(unduplicated individuals and geographic
area(s) – cities, counties, etc.)
Program Name
Description of the Request (1000
character max. Include main objectives,
rationale, methods to accomplish your
objectives, and anticipated results.)
Contact Information
Name, Title
Email, Phone
Page 9 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 4 of 10
Organization Background
The first five questions in this section 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.
Remember to answer all questions in this section at the organization level, NOT the program level. Be sure to
cite all statistics and research in a separate attachment.
Note: Character maximums include spaces. 2,000 characters with spaces is approximately equivalent to 325 words.
1. 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 timeframe 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?" (2,000 character max.)
2. What are your strategies for making this happen?
Describe your organization's strategies for accomplishing the long-term goals you cited in your previous answer. 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. (2,000 character max.)
3. What are your organization's capabilities for doing this?
Detail the resources, capacities, and connections that support your progress toward long-term goals. 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. (2,000 character max.)
4. How will your organization know if you are making progress?
Explain how your organization assesses progress toward your intended impact. 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. (2,000 character max.)
5. What have and haven't you accomplished so far?
Demonstrate recent progress toward your long-term goals 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 organization 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. (2,000 character max.)
Page 10 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 5 of 10
Program Request Information
Note: If you have already provided appropriate responses to any of the questions below in the
previous Organization Background section, simply type, “Answered in #___ of the Organization
Background section.”
This section focuses on the program(s) for which you are requesting funding. Be sure to include the most
recent data you have available to support your request.
1. Describe the program for which you are requesting funding, and the cause/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 effective by research. (2,000 character max.)
2. Present data that substantiates the need for the services you wish to provide. Describe the need for services
and the tools you use to identify need. If you have wait lists for your services, describe the reasons or conditions that
necessitate the wait lists, and how you prioritize them. (2,000 character max.)
3. Provide program service costs (direct and indirect) in the table below and describe how you arrived at
your service cost.
Program Service Costs (Note: Table below will expand should you need to include additional comments/clarifications.)
Unduplicated Individuals Served Total Program Costs Cost Per Unduplicated Individual
4. How will you make the program visible to those who would benefit from it? Specify whether the program
is new or existing. If the program is new, how do you plan to promote it? If the program already exists, how
are you currently promoting it? (1,000 character max.)
5. How do you coordinate, cooperate, or collaborate with other agencies to achieve your program goals?
Specifically highlight those organizations with which you have formalized agreements, such as Letters of
Commitment or Memoranda of Understanding. (2,000 character max.)
Coordination. Harmonious functioning of parts for effective results. Helping each other but not changing the basic way of doing
business.
Cooperation. Common effort and association for the purpose of common benefit. Helping each other in specific ways.
Collaboration. To work jointly with others on a common goal that is beyond what any one group can accomplish alone. (adapted
from: Forest, C. Empowerment skills for family workers: A worker handbook. Cornell University, 2003.)
6. Briefly describe what sets you apart from other nonprofits in the area and why your organization is best
situated to provide this service. (2,000 character max.)
Page 11 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 6 of 10
Evaluation
Define the primary goal or goals (up to 3) you hope to achieve through this funding for your program. The goal
identified below should be attainable within a 12-month period, and must relate to goals/outcomes articulated
in the Program Request section of this proposal. In this section, state your goal and provide your rationale for
why it is ambitious both externally and internally. To demonstrate that the goal is attainable, outline the inputs,
activities, outputs, outcomes, and performance measures. Definitions of each are listed below.
GOAL: What will this funding help you accomplish?
Example: Provide dental services to 34 unduplicated Granger residents who are living in poverty and who have
not received dental care in the past 12 months.
Ambitious-External: Why did you select this number/percentage as your goal? Please provide current,
comparative data that demonstrates that your goal is ambitious in light of the situation in your area. Credible
data sources include www.healthywilliamsoncounty.org, Georgetown Health Foundation’s 2015 Southeast
Georgetown Needs Assessment, US Census, American Community Survey, Data USA, etc.
Example: According to DATA USA, which pulls data from the 2015 American Community Survey, there are 1,583
residents in Granger and 21.7% or 344 residents are living in poverty. Our goal to provide dental services to 34
unique Granger residents who are living in poverty and who have not received dental care in the past 12 months
or more is ambitious externally because it will provide services to 10% of Granger’s residents living in poverty.
Further, the Centers for Disease Control show that only 58% of all Texas adults have visited a dentist in the past
year, which is lower than the national average of 62%. (Note: Because of Granger’s size and location, this is the
best data we are able to compile.) Our goal to provide services to Granger residents will increase the percentage
of adults receiving dental care in Texas, which is lower than the national average.
Ambitious-Internal: Why did you select this number/percentage as your goal? Please explain why this goal is
ambitious in light of your organization’s capacity.
Example: Our goal of serving Granger residents is ambitious internally because it will be our first attempt at
serving a rural community outside of our usual Round Rock/Taylor service area.
Inputs: Resources – human, financial, organizational, community – that a program or organization commits to
an effort.
Example: If funded, this grant will allow us to hire an additional part-time Health Navigator from the Granger
community. The Health Navigator will have access to all organizational and community resources including
professional development opportunities, office equipment, administrative support, materials (see Budget for
more detail).
Activities: What activities will support or accomplish your goals?
Example: The additional part-time Health Navigator will conduct outreach presentations at the three Granger
churches, at family activities at the Granger School and at community events at Granger Lake. The Health
Navigator will also provide case management to the 34 Granger residents served through this grant.
Page 12 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 7 of 10
Outputs: What do you expect these activities to produce? Outputs are often quantitative measures such as # of
participants, # of sessions held, # of encounters, so be sure to include anticipated benchmarks that will gauge
your progress.
Example: 34 unique Granger residents who are living in poverty and who have not received dental care in the
past 12 months or more will receive dental care during this grant period.
Outcomes: Specific, attainable, realistic result that shows the accomplishment of the strategy. What benefits,
impact, or changes in behavior, knowledge, skills, and/or attitudes for participants do you anticipate will result
from completion of the activities?
Example: The percentage of Granger residents who are living in poverty and who receive dental care during the
12 months of this grant period will increase by 10%.
Performance Measures: How will you know when you have accomplished your goal? How will you measure
and quantify results?
Example: Number of unique Granger residents who receive dental care through our organization’s services
during this grant period.
GOAL:
Ambitious - External
Ambitious - Internal
Inputs
Activities
Outputs (include
quantitative projections,
such as anticipated numbers
served)
Outcomes
Performance Measures
GOAL:
Ambitious - External
Ambitious - Internal
Inputs
Activities
Outputs (include
quantitative projections,
such as anticipated numbers
served)
Outcomes
Performance Measures
Page 13 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 8 of 10
GOAL:
Ambitious - External
Ambitious - Internal
Inputs
Activities
Outputs (include
quantitative projections,
such as anticipated numbers
served)
Outcomes
Performance Measures
Page 14 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 9 of 10
Organizational Support
SOURCES OF ORGANIZATIONAL SUPPORT (Prior Fiscal Year)
The purpose of this section is to provide a top line overview of your funding.
Sources Name(s) of Funder(s) Amount
Foundation Grants
Individual
Contributions
N/A – no need to disclose the names of individual
donors.
Corporate
Foundation
Support/Grants
Government Grants
Fundraising Efforts
Program Service
Revenue
Investment Income
Membership Income
Other (specify)
TOTAL REVENUE
CURRENT FISCAL YEAR DATES:
In your current fiscal year, what are your top 5 external sources of organizational support? Please list specific
funding entities and award amounts, indicating whether the funds are pending or in-hand. If a top source is
an individual donor, state “individual donor” with award amount.
1.
2.
3.
4.
5.
Page 15 of 19
Williamson County Funders
2018 Common Program Grant Application
Page 10 of 10
What are your cash reserves? How many months could you operate at your continued budget level?
What are your plans to ensure that the work described in this proposal is continued and supported beyond
this grant cycle? (1,000 character max.)
Page 16 of 19
City of Georgetown
STRATEGIC PARTNERSHIPS FOR COMMUNITY SERVICES
FY 2018-2019 Program Addendum
Responses to the prompts below will be reviewed to make an initial determination regarding an
organization’s eligibility for City of Georgetown funding.
Name of Organization:
Amount Requested ($10,000-$50,000):
Program Addendum
1. Describe how the proposed program aligns with one or more of the City’s priority areas
(Public Safety, Transportation, Housing, Veteran’s Services, Parks & Recreation, Safety Net).
500 character max.
2. To what extent do you educate and empower your target population toward self-sufficiency? If this
question does not apply to your request, insert “N/A”. 500 character max.
3. Does your organization currently receive any other monetary or in-kind assistance from the
City of Georgetown, including, but not limited to, subsidies for utilities, rent, or other
services. 500 character max.
4. Does this program provide opportunities for matching or incentive funds within your organization or
from other grantees? 500 character max.
5. Provide the total numbers served and the total number of Georgetown citizens served. 500 character
max.
Page 17 of 19
Program Budget City of Georgetown Grant Application for 2018-19-18
This format is required. Please enter your information into the shaded cells for rows applicable to the program for which you
are requesting funding. Use the column titled "Detail for this Grant Request" to show specifically how our grant will be used
in your Program Budget. If needed, there is space at the bottom to include narrative explaining your numbers & assumptions.
Name of Organization:
Budget Period From: To:
Total Program or Detail for this
Revenue/Support for this Program or Project Project Budget Grant Request
Individual contributions -$ -$
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 18 of 19
Program Budget City of Georgetown Grant Application for 2017-18
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:10/1/2018 To:9/30/2019
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 19 of 19