The Retirement Research Foundation
Proposal Cover Sheet
Organization’s Profile and Project Information
Instructions: Please complete this cover sheet, print it, and attach it to your full proposal. The tab key can be used to move to different sections in the cover sheet. Please note that information in section one must be consistent with regard to your organization’s legal name, EIN, and 501(c)(3) status. If you have questions, feel free to contact RRF at
773-714-8080 or .
I. Organization Information:
Legal Name of Organization:
(If the legal name is different than the name appearing on the 501(c)(3) documentation, please explain.)
If your organization does not yet have 501(c)(3) documentation, please check this box, and add relevant information to the final page of this cover sheet.
Address:
City: State: Zip:
Phone: Website: Year Incorporated:
Fiscal Year Begins: Current Fiscal Year Budget (expenses):
Employer ID Number (EIN):
Number of Full-Time Equivalent Staff:Number of Volunteers:
Mission:
II. Project Information:
Project Title:
Check if this is a 2nd or 3rd year request
Purpose:
A funding decision will be made approximately three months after the proposal due date; please keep this in mind with regard to project’s start date, end date, and timeline.
Estimated length of project: Start Date: End Date:
Total Project Cost: $ Amount Requested of RRF: $
Project Director Contact Information:
Name: Title:
Organization (if different from applicant organization):
Address:
City: State: Zip:
Phone: Email:
Check here if you would like to beadded to RRF email group.
If funding is requested for direct service, program replication, or advocacy project, indicate the target population to be addressed (estimate if needed):
Number to be served, engaged, or affected by project:
Percent ages 65 or older:
Racial/ethnic/other diversity characteristics:
Percent of target population that is low-income:
Geographic area:
Other characteristics of target population, if applicable:
How did you learn about The Retirement Research Foundation?
III. Authorized signers:
Chief Executive Officer:Board Chair:
______
Signature of CEO Date Signature of Board Chair Date
______
Print name above Print name above
CEO contact information:
Address:
City: State: Zip:
Phone: Email:
IV. Checklist for Proposal Completion
Please indicate that the following items have been completed and included with the proposal. Aside from the audit, all documents should be single-sided. Please do not use a ring binder, folder, plastic sleeve, or any other binding or cover for your proposal and attachments.
Cover sheet
Original signatures on the previous page of this cover sheet
Separate two- to three-page executive summary
Project narrative
Line item budget, with percentage of time for project staff
Budget narrative
Project timeline
Resume(s) for Project Director and other key project staff
Letters of support (if appropriate)
Letters of commitment from collaborators (if applicable)
List of current board members with affiliations
IRS letter documenting 501(c)(3) status or other evidence of federal non-profit status
Most recent financial audit (preferred) or IRS 990
Original and one copyof the cover sheet, proposal and attachments
(If submitting a research proposal, please send an original and 2 copies.)
If using a fiscal agent, please include the following items:
-A copy of the written agreement between the applicant and the organization serving as the fiscal agent.
The agreement should include a signature from the fiscal agent organization’s CEO (or equivalent) and a signature from the applicant organization’s CEO (or equivalent).
-501(c)(3) documentation for the organization serving as the fiscal agent.
-The fiscal agent’s most recent audited financial statement.
-Board of Directors list for the fiscal agent.
The Retirement Research Foundation 8765 West Higgins Road, Suite 430, ChicagoIL60631-4170
773/714-8080 phone773/714-8089 fax MS Word 01-14