Children’s Services Council Palm Beach County (CSC)

2017GREAT IDEAS INITIATIVE(GII) APPLICATION

NOTE:Only one application, in one category, may be submitted per funding cycle.

Total application should not exceed 5 pages.

  1. CONTACT INFORMATION

Organization Name:Click or tap here to enter text.

Contact:Click or tap here to enter text.

Email:Click or tap here to enter text.

Address: (Street; City; State; Zip; Phone)Click or tap here to enter text.

I,Click or tap here to enter text.(print name), hereby acknowledge that I read and understood the Great Ideas Initiatives Guidelines prior to submitting this application.

______
Signature(Date)

  1. ORGANIZATION INFORMATION
  1. What is your organization’scurrent annual operating budget?$Click or tap here to enter text.
  2. How many years has your organization been operational as a tax-exempt nonprofit? ______years. Please provide your organization’s IRS tax-exempt status (i.e. 501(d), 501(c)3, etc.) ______andFederal Employment Identification Number (EIN)______.
  3. Is your organization registered with the Florida Department of Agriculture and Consumer Services to solicit funds? ☐Yes ☐No (If not, explain why Exempt)______
  4. Please provide your organization’s mission statement and the geographic area(s) your organization serves.Click or tap here to enter text.
  1. GRANT CATEGORY

Was your organization awarded funding previously under the 2016 Great Ideas Initiative?☐Y ☐N

Which category is your organizationapplying for with this application? (Check only one)

Maximum request is $25,000

☐Essential Services Amount Requested: $______

☐Supplies/Equipment Amount Requested: $______

☐Community Outreach/Engagement Amount Requested: $______

☐Capacity Building Amount Requested: $______

  1. CSC/GRANT GOAL CONNECTION

Children’s Services Council’s goal is that all Palm Beach County children have an opportunity to grow up healthy, safe and strong. Provide a three (3) sentence overview of your proposed project. This must be short and concise, and will be used to communicate the purpose of project to CSC’s Council and various publications.Click or tap here to enter text.

  1. QUESTIONNAIRE
  1. Provide a description of your Great Ideas Initiative project. Include:a) the issue or problem that needs to be addressed in Palm Beach County, b) what you propose to do to address the problem, and c) if applicable, how your project aligns with the Youth Master Plan Steps to Success (pages 22-23 of the YMP) and/or the 10 Goals of the Hunger Relief Plan for PBC (Pages 5-8). Please include any relevant data that supports your idea (e.g. evidence of need for the population; what services and/or resources are needed). Click or tap here to enter text.
  1. Provide an overview of your project implementation plan. Detail: a) how the proposed idea will be accomplished, b) what activities/resources will be delivered or made available to support the anticipated impact, and c) a timeline for completion. Do you foresee any implementation challenges? If so, how will you address them? Click or tap here to enter text.
  1. Who is your target audience for this project? Include any demographic characteristics of your target audience and specific geographic area you would be targeting. If applicable, address how you plan to identify and reach the intended beneficiaries of your proposed project.Click or tap here to enter text.
  2. How will this grant make a difference? Describe the anticipated impact or benefits of this grant on your target audience. How will you measure your program success (how much did you do; how well did you do it; who’s better off as a result)? What are the strengths of your organization that will support successful results?Click or tap here to enter text.
  1. Provide an itemized project budget and budget narrative. Please indicate how the Great Ideas Initiative funding will be utilized (include calculations where necessary) as well as any other funding sources, including in-kind. Do not include indirect expenses in your request(those expenses that are incurred to operate a business as a whole or a segment of a business, and so cannot be directly associated with a cost object, such as a product, service, or customer).Click or tap here to enter text.

Your signature below indicates your commitment to follow through with the resources you have requested in the application and to provide a Project Completion Report and Financial Reconciliation Statement.

Executive Director or official/individual authorized to bind the organization to this application

Print Name:

Signature:(Date)

  1. SUBMISSION CHECKLIST

Before submitting your application, be sure the following elements are included:

Did you complete each portion of the application, check the correct category box and review the thoroughness and completeness of your answersto the questions?

Did you sign the acknowledgment/understanding of the Great Ideas Initiative Guidelines, including exceptions to funding?

Is the application signed and dated by the organization’s executive director orby another official/individual who is legally authorized to bind the organization to this application?

Did you include your organization’sFederal Employee Identification Number?

Did you stay within the 5-page limit for yourorganization’s application?

Applications must be received by 2:00 p.m. on August 7, 2017. Proposals received after the deadline date and/or time will be rejected and will not be opened by CSC.

Submit one (1) original and five (5) copies to:

Children’s Services Council of Palm Beach County

Great Ideas Initiative

2300 High Ridge Road

Boynton Beach, FL 33426

Attn. Jennifer Hardy, CSC Operations Associate

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