Strategic Investment Application

2016-2018 Investment Application

2016-2018

Leveraging resources to help people, change lives, and make your community investment count throughout the Cedar Valley.

Program Name:

Organization Requesting Funds:

Address:

Application Contact Name:

(All correspondence regarding this document will be through this person.)

E-Mail: Phone:

CEO or Executive Director:

E-Mail: Phone:

Organization Mission Statement:

CVUW Request: $Total Program Budget: $

Total Agency Budget: $

How does this program define a participant? ______

How many participants,as defined above, does this program intend to actively engage between July 1, 2016 and June 30, 2017? ______

Brief summary of program (Limit of 50 words): Thisinformation will be used for publicity and marketing purposes.

Part 1: Organizationand Program Overview

Organization Overview: Provide a brief overview of your organization, including the history, services and programs, and current strategic direction. It is not necessary for organization with long histories to provide extensive detail. Your response in this section is limited to 300 words.

Program Narrative: This section is your opportunity to present a thorough and concise description of the work for which funding is being requested. Please write in such a way that a reader who does not know abo ut your work will be able to visualize and understand it.

Alignment with Cedar Valley United Way Community Impact Strategies: Select the target area and community impact strategies with which you align, as well as a minimum of two outcome indicators per strategy on which you will report biannually.
Please also attach (if applicable) the survey that will be used to gather information from your clients for any self-reported outcome indicators selected, as well as the assessment tool (pre/poste-test) used for outcomes selected pertaining to increased client knowledge
Acknowledging that you may already collect data and report on other outcome measurements not included in our list, you may also report on up to 2 additional measures that you track within the program if you desire. These measures should also support the strategy area in which you are applying.

Target Population: Based on the community impact goal(s) you’ve selected, describe the demographic of the target population this program will serve. Is there a targeted geographic area within the community? Explain how participants will be identified/recruited and the criteria individuals and/or families must meet in order to be eligible for this service. (300 word max)

Statement of Need: Provide a description of the community conditions and local data that document the need for the services your program will provide. Discuss any increases or decreases in services provided and/or number of clients served. How isyour program effective and efficient in meeting the community need? Describe steps taken to ensure you are addressing an unmet need and are not duplicating existing services, or explain why duplication is necessary. (400 word max)

Program Summary: Describe the program’s primary goals. Please list and describe the main components and essential tasks, projects and/or services that directly impact program goals and outcomes. Also include anticipated/proposed targetsfor each of the components over the course of the two-year grant cycle. (500 word max)
Timeline: Provide a timeline indicating the frequency and duration of the program components from the perspective of the client (such as number of hours/week participants receive service or total number of months participant engages, etc.), as well as whenkey milestones occur. If specific dates are associated with key activities, such as enrollment, graduation or completion, and/or other activities, please include them. Please upload an outline or chart for this section, which will not be included in the 500 word max.

Part 2: Service Delivery: This section is intended to help us further understand the scope, responsiveness and rationale for service strategies within the community.

Background: Tell us how long you have provided the specific services described. Also include any significant evolution in this area of your work, especially in response to societal, legislative and/or economic changes. (150 word max)

Rationale: Pleasetell us why you have chosen your specific strategies, programs, and/or services. Is your program based on research or evaluation results? Would you characterize your work as “best practice” or “evidence-based?”If your work is based on evaluation results or studies, refer to those. (300 word max)

ProfessionalQualifications: What relevant certifications and/or credentials do your direct care staff possess that increase the effectiveness of services provided? What progress is being made towards the attainment of relevant certifications or credentials? What other essential training and developmentis conducted with staff to ensure effectiveness? If this is not applicable for your services, please explain why specific professional skills are not necessary for effective service delivery. (200 word max)

Continuum of Care: Provide an overview of linkages you provide to other services within your organization, or linkages that you make for clients to other organizations that support the needs of your clients. (200 word max)

Part 3: Program Evaluation

Data Monitoring: Describe your organization’s ability to report on the outcomes specified in this application. What data do you collect and how? At what points in time? What tool(s) do you use to collect and analyze these data? (300 word max)

Quality Improvement: Describe how your organization learns from and incorporates performance measurement findings in order to improve planning, strategy, and service delivery. (300 word max)

Performance Goals: Provide your recent actual results that have been used to measure and monitor the effectiveness of this program to participants. What are your goals for the outcome indicators (selected in the Program Narrative, section 1) for the upcoming fiscal year? How are these goals determined? Are there benchmarks, organizational expectations, and/or state/national averages that guide your performance standards? (300 word max)
Your recent actual results can be uploaded here if they are in a format that cannot be easily shared above

Part 4: Budget

Using the Budget Worksheet, provide the complete program budget. Please also include a narrative explaining projected expenses and revenues. Note any substantial changes that are forecasted for July 1, 2016 – June 30, 2017. Include information about additional sources of revenue for the program, and what effects there will be on the program if these additional sources should not be available. Indicate what your program would do without, or with a lesser amount, of funding than was requested. Please also define any expenses listed in the “Other” line item.

If the program requesting funding is eligible for matching funds, please describe the impact and the mechanism of the matching funds and their impact on the program. For example, if CVUW allocates $10K to Program X, these dollars will be matched by $10K from another source, allowing for 35 additional program participants and increased outcomes in the following areas______. If no matching dollars occurs in your program, please specify this. (Matching funds are dollars leveraged by United Way funds, not just additional program dollars from other sources.)

Budget Worksheet

Please provide projected budget for July 1, 2016-June 30, 2017

Projected Expenses / Total Budget / CVUW Request / Projected Revenues / Budgeted / Actual $ Secured in 2015
Personnel / Cedar Valley United Way
Benefits / Government-Local
Rent / Government-State
Utilities / Government-Federal
Office Supplies / Foundations
Program Supplies / Grants
Training / Individual/Corporate Donations
Mileage / Special Events
Equipment / In-Kind
In-Kind / Program Fees paid by participant
Fundraising / other
Scholarships/How Many / Totals
Direct Assistance to participants
Other
Totals:

Page 1 of 6