CARROLL H. STARR ENDOWMENT CHALLENGE VIII APPLICATION

  • This document contains all the questions for CFNIL’s Spring 2016 Community Grants Application. All applications must be submitted online at: CFNIL is making this document available so applicants can work on their proposals when they do not have internet access. No paper copies of the application will be accepted.
  • For application guidelines, instructions, deadlines and grant program information visit
  • CFNIL will not accept proposals submitted after the deadline.
  • Highlighted text indicates non-required questions.

ORGANIZATIONAL INFORMATION

  • Organization Name
  • Organization Mission/Goal Statement
  • Organization EIN
  • Organization Street Address
  • Organization City
  • Organization State
  • Organization ZIP
  • Organization County
  • Organization Phone Number
  • Organization Website
  • Organization Logo
  • Organization Facebook
  • Organization Twitter
  • Please attach a list of your organization’s Board of Directors and identify officers.

Enter information below regarding the Chief Executive Officer (CEO) of the applying organization. (Official correspondence will be sent to this individual's attention, including proposal status letters and grant payments.)

  • CEO Prefix
  • CEO First name
  • CEO Last Name
  • CEO Title
  • CEO Email
  • CEO Direct Work Phone Number
  • CEO Phone Extension

Enter information below regarding the Primary Contact (PC) for questions about this application.

  • PC Prefix
  • PC First Name
  • PC Last Name
  • PC Title
  • PC Preferred Phone Number
  • PC Phone Extension
  • PC Email
  • PC Street Address
  • PC City
  • PC State
  • PC Zip Code
  • In which year was your organization founded?
  • Briefly summarize your organization’s history:
  • Describe your organization’s current programs and activities
  • Describe your organization’s recent accomplishments
  • List the total number of staff, given in full-time equivalent (FTE) units:

ORGANIZATIONAL FINANCES

  • Attach your organization’s year-to-date income statement compared to budget.
  • Date of your most recent 990 or your most recent financial statement
  • Indicate the document from which you are reporting
  • 990
  • 990-N
  • 990-EZ
  • Cash and Current Assets (Total Lines 1 thru 5, Column B, Part X)
  • Other Assets (Total Lines 6 thru 15, Column B, Part X)
  • Total Assets (Line 16, Column B, Part X)
  • Current Liabilities (Total Lines 17 thru 19, Column B, Part X)
  • Other Liabilities (Total Lines 20 thru 25, Column B, Part X)
  • Total Liabilities (Line 26, Column B, Part X)
  • Total Net Assets (Line 33, Column B, Part X)
  • Contributions, Gifts, and Grants (Line 1h, Column A, Part VIII)
  • Total Revenue (Line 12, Column A, Part VIII)
  • Total Program Service Expenses (Line 25, Column B, Part IX)
  • Total Management and General Expenses (Line 25, Column C, Part IX)
  • Total Fundraising Expenses (Line 25, Column D, Part IX)
  • Total (Functional) Expenses (Line 25, Column A, Part IX)
  • Total Expenses (auto calculated)
  • Please use this space to clarify anything about your organization's finances.
  • Use this field to upload any additional financial documents.

SERVICE POPULATION

  • Approximately how many individuals does your organization serve annually in Boone, Ogle, Stephenson and Winnebago Counties?
  • Describe the target population of your charitable services.

For each category below, enter the approximate number served in an average year. If project demographic data does not exactly match the categories listed, please use your best estimate to divide the data into matching categories. Enter 0 if none.

  • Residents of these counties:
  • Boone
  • Ogle
  • Stephenson
  • Winnebago
  • Other
  • Race/Ethnicity:
  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Hispanic or Latino
  • Native Hawaiian or Other Pacific Islander
  • Other
  • Unspecified
  • White
  • Two or More Races
  • Ages:
  • All
  • Children (0 to 11)
  • Youth (12 to 18)
  • Adults (19 to 65)
  • Seniors (66 and up)
  • Genders:
  • Male
  • Female
  • Other

ENDOWMENT VISION

  • What is your organization’s total goal for the Carroll H. Starr Endowment Challenge? (This includes contributions from your organization and the match from CFNIL.)
  • How much will your organization contribute to the Carroll H. Starr Endowment Challenge? (This will be 75% of your organization’s total goal.)
  • Why did your organization choose this amount?
  • How much are you seeking in a challenge grant from CFNIL? (This will be 25% of your organization’s total goal.)
  • Please describe your organization’s plan to reach your CHS Endowment Challenge goal.
  • Please estimate the percentage of your organization’s goal that will come from the following sources: (Total should add up to 100%)
  • Program Service Revenue:
  • Bequest or estate gift (anticipated):
  • Bequest or estate gift (realized):
  • New fundraising campaign specifically for CHS Endowment Challenge:
  • Surplus from prior year:
  • Donations from the Board of Directors:
  • Other sources:
  • Y/N: Does your organization currently have an endowment?
  • If Yes: What is the value of your organization’s total current endowment? (Can be a total of multiple funds.)
  • If Yes: Is this endowment held at CFNIL?
  • Explain why creating an endowment through the Carroll H. Starr Endowment Challenge is important to your organization.
  • Explain how the distribution from an endowment will be used to strengthen your organization.
  • Describe in detail how your organization will communicate its participation in the CHS Endowment Challenge with your donors.
  • Please attach a letter from your Board President affirming your organization’s commitment to creating an endowment at CFNIL.
  • Y/N – Does your organization plan to continue growing your endowment at CFNIL after completing the Carroll H. Starr Endowment Challenge?

CHS ENDOWMENT CHALLENGE AGREEMENT

By submitting this application for the Carroll H. Starr Endowment Challenge (hereafter “CHALLENGE”), your organization (hereafter “GRANTEE”) agrees to the following terms and conditions of the Community Foundation of Northern Illinois (hereafter “FOUNDATION”).

  • To establish a permanent agency endowment at the FOUNDATION.
  • To complete its fundraising activities as it relates to the CHALLENGE within two years of establishing a permanent agency fund at the FOUNDATION. The FOUNDATION will deposit matching funds into the grantee’s endowed fund immediately after the grantee has complete their fundraising goal for the CHALLENGE.
  • The grantee will be responsible for all fundraising activities.
  • To give reasonable access to the grantee’s files and records for the purpose of making such financial audits, verifications, and investigations as it deems necessary concerning the CHALLENGE and to maintain such files and records for a period of at least four years after completion of the CHALLENGE.
  • To allow the FOUNDATION to include information about this grant in the FOUNDATION’s periodic public reports, newsletter, news releases, social media postings, and on the FOUNDATIONS’s website. This includes the amount and purpose of the grant, any photographs you have provided, your logo or trademark, and other information and materials about your organization and its activities.
  • The grantee will notify the Foundation immediately of any change in (A) the grantee’s legal or tax status and (B) the grantee’s executive or key staff responsible for the CHALLENGE.