The Dayton Foundation  40 N. MAIN STREET, STE 500  Dayton OH 45423  937-222-0410 937-222-0636 (fax)

2015Final Report Information (continued)

Combined Harmony Campership
2015 Final Report and 2016 Application
Must be postmarked by September 26, 2015 / For TDF Use Only
App Rec’d: ______
Amt Req: ______
Amt Awd: ______
Grant #:DI2016-______
CampName: / Street Address:
Sponsoring Organization/Camp Owner (where camp is held): / City, State and Zip Code:
Name and Title of Contact Person: / County:
E-mail: / Phone: / Fax:
Note: All information requested applies to resident camping sessions exclusively sponsored by your organization and open to all campers, not to organizations or camps which may rent your camping facilities.
Actual
2015 / Anticipated
2016
  1. Number of summer resident campers served (attended a minimum of four days)

  1. Number of summer resident sessions operating a minimum of four days

  1. Length of summer resident session (days and nights)

  1. Maximum resident capacity per basic summer session

  1. Resident camper/staff ratio for basic summer resident camp

  1. Published fee per camper for basic summer resident camp

  1. Actual cost per camper for basic summer resident camp

  1. Range of sliding fees, if any, for basic summer resident camp

  1. Number of camperships for basic summer resident camp
    (including Harmony camperships)

  1. Total amount of campership funds for basic resident camp
    (including Harmony camperships)

  1. Average campership for basic summer resident campers
    (including Harmony camperships)

  1. Number of children unable to attend due to lack of funds

Actual
2015 / Anticipated
2016
  1. Number of campers who benefited from Harmony camperships

  1. Range of dollars given per Harmony camper

  1. Average amount given to Harmony campers (divide The Dayton Foundation campership amount by the number of campers who received Harmony funds)

  1. Date and Location of Camp Session(s)

  1. List the counties represented at your camp and the approximate percentage of your total camp population in each:

  1. List the number residents who received Harmony Camperships by county: (Harmony Camperships must be awarded to residents of Montgomery, Greene, Clark, Darke, Miami, Preble, Butler, or Warren Counties in Ohio).
Montgomery:
Greene:
Clark:
Darke:
Miami:
Preble:
Butler
Warren:
  1. Describe the population (ethnicity, economic status, age, etc.) of your campers, preferably using percentages if available.

  1. In general, how did this year's camping program differ from last year's? What changes, if any, do you anticipate for your camping program in future years?

  1. What are the goals for your campers and how do you measure or plan to measure your success?

  1. What is the evidence that shows your program is effective?

  1. What is your greatest challenge(s) as a camp director?

  1. Please share your comments, concerns and suggestions about the Harmony Campership program.

  1. Describe any requirements you may have for your campers to receive campership funds.

  1. Describe your recruiting efforts, criteria used to select camp staff, and your staff training process, including duration and subject matter. What, if any difficulties do you encounter in recruiting competent staff?

  1. Additional information you would like us to know about your camp:

  1. Campership:
/ Received in 2015: / Request for 2016:
  1. For health/medical camps only, describe the health/medical aspects of your camp.

  1. Please include a separate, detailed income and expense statement for 2015 and a detailed projected income and expense budget for 2016 listing source and amount of contributions from the following:
  2. Foundations
  3. Corporations, Businesses
  4. Fraternal Organizations
  5. Fundraisers (please specify)
  6. Governments Sources (federal, state, local)
  7. Harmony Funds
  8. Individuals
  9. Service Organizations
  10. United Way
  11. Other (please specify)

I have enclosed the following required information:
The income and expense financial report for the 2015resident camping program (please do not send the financial report for your entire organization).
The income and expense budget for the 2016 resident camping program (please do not send the budget for your entire organization)
A camp brochure and/or other camp literature
A copy of your organization’s IRS 501 (c) 3 letter
Copy of your organization’s diversity policy
Copy of your certificate of accreditation. Your camp must be accredited for 2016 to receive funding.
By signing below, I certify that this camp admits campers without respect to race, creed or economic status and that all of the information contained herein is true and correct to the best of my knowledge.
Name (Executive Director, President, or legally authorized official) / Title
Address (if different from camp director) / State, Zip Code

Signed:______Date:

This final report/application, including the required enclosures, must be postmarked no laterthan

September 26, 2015.

If you have questions or need additional information, please contact:

Beth Geiger at 937-225-9964 or 1-877-222-0410 (toll free) or

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P:\Grants\BethG\Harmony Camperships\2016\Harmony-APPLICATION 2016.doc