Financial Stability Response Fund

PROGRAM APPLICATION EVALUATION

/ Possible Score / Score

Question1

A.The agency provides a clear mission statement and a concise history of services which aligns with their mission.

/ 5

B.The agency provides a description of their current programs, including:

  • population served
  • geographic area
  • services provided
  • description of services in support of financial stability
  • results achieved in previous program year
/ 5

Subtotal for Question1

/ 10

Question 2

A.The agency provides a general description of a quality program that aligns with the area of focus and demonstrates experience. Description includes:

  • Activities
  • Processes used by the agency
  • Target population
  • Described past experiences delivering proposed services, including number of clients served if applicable.
/ 10

B.The agency’s list of community partners demonstrates that it has strong relationships with key organizations in the community, especially those directly involved in Financial Stability services.

/ 5

Subtotal for Question2

/ 15

Question3

A.The program clearly and concisely outlines a detailed plan that demonstratesintegration with the CFS.

/ 10

B.The proposed intake, assessment and coordination of services (including the flow chart provided) are reasonable and logical. The coordination of services exhibits integration of key services between the CFS and the applicant’s program.

(See flow chart) / 10

Agency Name: ______

Program Name: ______

C.The proposed estimated number of clients to be served is reasonable and the description of the target population and typical client profile demonstrates that the agency has a good understanding and fit with Center for Financial Stability services.

/ 5

D.The proposed data tracking and measurement system demonstrates that the applicant has strong data collection and a methodology that will collect the appropriate and necessary data to properly evaluate the success of the clients.

/ 5

E.The outcomes that the applicant proposes are strong and demonstrate significant client impact and understanding of the concept and purpose of the Center for Financial Stability. The data collected will allow the agency to determine whether the outcomes are being achieved.

/ 10

F.The proposed logic model presents a logical connection between inputs, activities, outputs and outcomes. The logic model is consistent with information provided in the proposal.

/ 10

G.The proposed services clearly illustrate how partnering with the Center will complement their services and improve client outcomes.

/ 5
Subtotal for Question 3 / 55
Question 4
  1. Thebudget form is complete and consistent with the program design.
/ 5
  1. The budget narrative is specific and the funding request is reasonable for the proposed number of clients to be served.
/ 5

C.The program clearly describes how United Way funding will be used.

/ 5

D.The program receives significant and diverse financial support.

/ 5

Subtotal for Question 4

/ 20

PROGRAM APPLICATION SUMMARY

/ Possible Score
Summary:
Question 1 / 10
Question 2 / 15
Question 3 / 55
Question 4 / 20
Program application review total
/ 100

Reviewer: ______

1