Letter of Intent Cover Page

2016-2017 Community Investment Grants

Complete the required LOI documents and then combine into one(1) .pdf file. E-mail to LeAnn Powers () before 5:00 p.m., Thursday, January 21, 2016.

Note: ONLY electronic submissions will be accepted. The time of submission is the date & time indicated in the Inbox of LeAnn Powers, not the Sent time of the Sender. Late or incomplete submissions will not be accepted.

Agency Name
Agency Website
Agency EIN
Agency Mailing Address (City, State, Zip)
Agency Street Address (City, State, Zip)
Agency Phone
Agency Director ED/CEO
Agency Director Phone
Agency Director Email
Agency’s Primary Contact for Application
Title of Primary Contact
Primary Contact Mailing Address (City, State, Zip)
Primary Contact Street Address (City, State, Zip)
Primary Contact Phone
Primary Contact Email
Agency Board Chair
Agency Board Chair Phone
Agency Board Chair Email
Project/program name:
Amount of funding requested:Minimum request of $10,000, increased increments thereafter of $5,000 and not to exceed $40,000. / $______

Letter of Intent Outcome Checklist

Please check the box of at leastONE United Way of Williamson County Outcome to which your program aligns.Important Note:You can certainly choose more than one, but if you receive a grant from United Way of Williamson County, you will be required to report on at least ONE of the Indicators listed within each/all of the Outcomes you have selected. Please plan accordingly.

Focus Area / Goal / Outcome
Education / Goal: Increase percentage of children who enter school (kindergarten) ready to learn. / Parents/guardians/care givers use acquired knowledge to improve their child’s academic preparedness.
Indicators:
  1. Number of parents/caregivers receiving training and information
  2. Number of parents/caregivers indicating an increase in knowledge about improving their child(ren)’s language and literacy skills.

Children enter school with the necessary foundational skills needed to begin pre-kindergarten and kindergarten learning.
Indicators:
  1. Number of parents that indicate they regularly read to their child(ren).
  2. Number of pre‐k and kindergarten teachers that indicate the child(ren) in the reading programs are ready for kindergarten.

Goal: Increase the percentage of young people graduating from high school on time. / Youth will have improved self-esteem, better classroom behavior, reduced truancy and increased interest in school.
Indicators:
  1. Number of volunteer mentor/mentee matches.
  2. Number of youth with improved attendance.
  3. Number of youth with better classroom behavior.

Youth demonstrate improved school academic performance in one or more core subjects.
Indicators:
  1. Number of tutors and number of tutored students.
  2. Number of youth that improve their grades in one or more cores subjects.

The family/ caregiver of at-risk youth will be more involved in their child’s learning and development.
Indicators:
  1. Number of families/caregivers attending programs on life skills, life management and family engagement.
  2. Number of families/caregivers that report they have increased knowledge & skills in order to support their child(ren)’s academic success

Focus Area / Goal / Outcome
Health / Goal:Increase access to prevention programs / Individuals use their acquired knowledge to better manage their chronic disease.
Indicators:
  1. Number of people attending workshops focused on Chronic Disease Management.
  2. Percent decrease in clinical markers of people attending workshops.
  3. Number of people that indicate they have improved their knowledge about their Chronic Disease.
  4. Number of people indicating they can better manage their disease as a result of participating in an education and/or prevention program.

Children and adults that have been affected by physical, sexual or domestic abuse/violence will feel safe and be able to rebuild their lives.
Indicators:
  1. Number of clients/families who report that they can now make an informed choice regarding their safety
  2. Number of children reported to have an improvement in trauma-related symptoms.

Seniors with limited resources will feel less isolated, maintain good health and continue to live in their own home or that of a family member.
Indicators:
  1. Number of seniors receiving nutritious meals once a day.
  2. Number of seniors receiving transportation to the doctor or grocery store.
  3. Number of seniors (or their caregivers) reporting the ability to live in their home and avoid assisted living.

Goal:Increase access to quality primary care (prenatal through adult) /  Uninsured Williamson County residents will have access to a medical home and will not need to use the Emergency Room for non-emergency medical care.
Indicators:
  1. Number of people assisted with enrollment in the Health Insurance Marketplace
  2. Number of people counseled regarding the Health Insurance Marketplace.
  3. Number of new/unduplicated individuals connected to a medical home
  4. Percent of patients that report avoiding the Emergency Room visit due to access to healthcare.

Focus Area / Goal / Outcome
Income/
Financial Stability / Goal:Increase income, assets and job training for improved employability. / Individuals use their acquired knowledge to improve their financial stability.
Indicators:
  1. Number of individuals attending financial literacy classes.
  2. Number of individuals that report that they have improved their financial ability to meet their basic needs.
  3. Number of individuals that report they have increased their financial knowledge on how to properly handle debt, budgets, savings & credit.

Individuals utilize their training, support, education and credentials to obtain a position in a field that provides a sustainable wage.
Indicators:
1.Number of individuals receiving training, support, education and credentials in programs that enhance employability.
2.Number of individuals obtaining a position in a field that provides a sustainable wage.
Individuals make sound financial decisions that result in increased savings and assets.
Indicators:
  1. Number of federal tax returns completed.
  2. Number of individuals who claim the Earned Income Tax Credit.
  3. Number of individuals participating in a matched savings program.
  4. Number of individuals attending self-employed coaching classes.

Focus Area / Goal / Outcome
Basic Needs / Goal: Address nutrition, utilities and housing needs across the county. / Individuals and families in crisis will have their immediate basic needs met.
Indicators:
1.Number of individuals and families receiving free, balanced, nutritional food
2.Number of individuals and families who avoid eviction or utility disconnection

Letter of Intent Outline

2016-2017 Community Investment Grant

Complete the following outline to describe the program/project for which you are applying for a United Way of Williamson County Community Investment Grant. Expand each section as needed but do not exceed four pages (The 4-page limit DOES NOT include the Cover Page, Outcomes Checklist or Checklist/Signature page). If applying for more than one project/program, a separate LOI outline must be submitted for each.

Organization______

  1. Brief description of the organization with mission statement.

Include all of your current programs and provide statistical and demographic information on those being served by these programs (be sure these statistics indicate those being served in Williamson County).Limit to two paragraphs and/or approximately 250 words.

  1. Proposed project/program name______

Amount of funding requested______

Describe your project/program

This section should include, but is not limited to, targeted population, project/program methods of implementation, staff and/or volunteer resources, project/program location(s), project/program length.

  1. Will this program/project be part of a collaborative or partnership effort within the community?

Please include a listing of all agencies, businesses, schools, government entities and others, as well as a description of how these collaborations work together to assist in the success of this project/program.

  1. Description of need in Williamson County as it relates to your LOI project/program request.

Limit to two or three paragraphs.Be sure to include statistical information supporting the need specific to Williamson County and site references used. Also be sure to include information on how your organization is working to meet this need and how many you currently, or will, serve.

  1. Describe your organization’s strengths and ability to deliver the project/program.
  1. Description of the continuation plan for this project/program.
  1. Please restate the Focus Area, Goal & Outcomeyou chose from the Outcome Checklist:

Focus area
Goal
Outcome(s)

Describe in detail how your project/program will help achieve the above Goal/Outcomethat you chose from the Outcome Checklist. (If you checked off more than one Outcome, then copy and paste the above chart and description space as needed.)

Please be sure that the information listed here is specific, measurable, attainable, realistic, time-sensitive. Short-term and long-term community impacts of the project/program should also be included. Please include how the project/program outcomes will be measured and evaluated, as well as the methods or tools used in this process.

  1. Estimated numbers to be served/impacted by the project/program in Williamson County.

Please be specific as to how many and in what parts of the County (cities/regions/areas) this program will reach/serve.

  1. A brief budget outline indicating cost for services (a full one-page project/program budget should be attached separately) and include how the UWWC grant funding would be used.

Specifically include the per person cost of service for this project/program.

  1. Project/program timeline.


Letter of Intent Checklist/Signature Page

2016-2017 Community Investment Grant

  1. Please print out this page.
  2. Check off the items listed below to indicate that they are included in your LOI Application Packet.
  3. ED/CEO must sign.
  4. Scan this completed Checklist & Signature Page and include it at the end of your LOI Application Packet.

Completed Cover Page.

Completed Outcome Checklist.

Completed Letter of Intent Outline using the outline provided in this Application Packet (no more than 4 pages when expanded).

Included a one page project/program budget that shows all funding sources and expenditures.

Included a copy of the organization’s IRS 501(c)(3) Letter of Tax Exempt Status.

Included a current list of the Board of Directors with addresses.

Included a list of the Board of Directors 2016-2017 meeting schedule.

Completed the Checklist & Signature page and included it in the LOI Application Packet.

Converted all of the above into one(1) .pdf file.

Did not include additional items, marketing materials, newspaper articles, etc.

E-mailed the completed LOI Application Packet, in .pdf format, to before 5 pm on January 21, 2016.

Signature

Executive Director/Chief Executive Officer:______

Date:______

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United Way of Williamson County Community Investment Grant Letter of Intent