Grant Procedures

Community Health Initiative Fund

Centra Foundation

All funding requests for projects or programs should be sent to:

Dr. Kathryn M. Pumphrey

Executive Vice President, Centra Foundation

1920 Atherholt Road

Lynchburg, VA24501

Grant proposals submitted for funding from the Centra Community Health Initiative Fund will be reviewed once a year by its grants committee. To receive consideration, proposal should be sent by the March 1 deadline.

Restrictions

There are grant type requests which do not meet the fund’s established criteria. As a rule, the Centra Community Health Initiative Fund will not provide for:

  • Individuals
  • Institutions of organizations which do not qualify as tax exempt by the Internal Revenue Service
  • Endowment campaigns
  • Attending conferences or symposiums
  • Travel
  • Athletic organizations

Application Guidelines

Submit proposals in letter form no longer than ten pages. Do not submit binders. Please send 22 copies of your proposal along with a completed executive summary form. Each proposal should include the following:

  1. A brief description of the organization, its history and purpose.
  2. Title of the grant.
  3. A concise description of the project or activity proposed, including the specific purpose for which the grant is requested, the health-related benefits to be provided and the needs to be met. Please describe how your project specifically relates to community health problems and issues outlined by Centra Health’s Community Health Assessment.
  4. Names and addresses of the organization’s trustees, directors, advisors and principle staff.
  5. Name, address and phone number of the key individual responsible for the grant request.
  6. A copy of the determination letter form the IRS that the organization is exempt form federal income tax under Section 501(c)(3) and is not classified as a private foundation or private operating foundation as defined in Section 509(a) of the Internal Revenue Code.
  7. A current audited financial statement showing the major source of organizational support and endowment, if any.
  8. A budget for the project that includes the total cost of the project and the specific amount requested from the Centra Foundation. State all expected itemized expenses. If applicable, please list other sources of funding available to you for the project and list any funds you have already secured for the project.
  9. Specific measures that will be used to evaluate how the project will improve community health.
  10. A cover letter from an official of the organization stating tat the board of directors of that organization has formally approved the proposed program.

Instructions for Grant Submissions

Community Health Initiative Fund

Centra Foundation

Each proposal narrative should be submitted in letter form with numbered pages and be no longer than ten pages.The Executive Summary Form does not take the place of the proposal narrative. Each narrative should include the following:

  1. a brief description of the organization, its history and purpose,
  2. title of the grant,
  3. a concise description of the project of activity proposed,
  4. any specific measure that will be used to evaluate how the project will improve community health.

Please assemble you proposal submission as follows:

  1. Executive Summary Form as cover sheet
  2. proposal narrative
  3. names and addresses of he organization’s trustees, directors, advisors and principle staff
  4. names and address of the key individual responsible for the grant request
  5. a copy of the 501(c)(3) determination letter fm the IRS
  6. a budget for the project that includes the total cost of the project and the specific amount requested from the Centra Foundation.

Only one cover letter and audited financial statement per organization is required for each submission package.

Please send 22copies of you proposal. The pages of each proposal copy should be stapled together. Please do no use paper clips, binder clips or binders. Do not send any attachments or brochures.

If you hand deliver your submission package to the CentraSupportBuilding, make sure your delivery is acknowledged by the Centra receptionist or a Centra Foundation staff member.

If additional information about the proposal is needed, Dr. Kathryn M. Pumphrey, Executive Vice President of the Centra Foundation, will contact the grant applicant.

For further information on the Community Health Needs Assessment, contact: Dr. Kathryn Pumphrey, Centra Foundation (434.200.4790)

Executive Summary Form

Community Health Initiative Fund

Centra Foundation

(to be attached as a cover sheet to your proposal)

(Must be typed)

  1. Full name of applicant organization:
  1. Contact person for grant (include title, address and phone number):
  1. Name and address of person to receive notification of grant award:
  1. Project title (make sure title of project matches request for funding information):
  1. Amount of request:
  1. Brief description of project:
  1. Rationale for the project:
  1. What percentage do you expect the Centra Foundation’s contribution toward the total project cost to be?
  1. Target population and geographic scope:
  1. Funds will be used for:
  1. Specific objectives of the project and time frames:
  1. Key players in implementation and operation of the project:
  1. Sources of other funding for this program:
  1. Evidence of community collaboration:
  1. Plans for future funding of this program:

Is your organization qualified charity under Section 501(c)(3) of the Internal Revenue Service Code? Yes  No 

Applicant taxpayer number: ______

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Summary of Program Outcomes for Grant Awards

Community Health Initiative Fund

Centra Foundation

Name of project:______

Name of organization:______

Date project started:______

Date project completed:______

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