2011 Social Enterprise Academy Application

2011 SOCIAL ENTERPRISE ACADEMY APPLICATION

DUE 5 PM, FRIDAY DECEMBER 10, 2010

Organization:______

Executive Director:______

Project Director, if different: ______

Title:______

Mailing Address:______

Office Phone:______Mobile:______

Email Address: ______

My signature below indicates our organization’s commitment to and understanding of the following program requirements:

v Phase I: Orientation Meeting/Site Visit, Workshop Series, Business Feasibility Planning and Social Enterprise Showcase (January through June 2011)

o A team of three to five people from my organization will participate in the workshop series, feasibility plan development work and the Showcase, investing 8 to 10 hours each per month

v Phase II: Social Enterprise Leadership Forum series

o The Social Enterprise project team leader from our organization will participate in monthly Forum meetings, from July through December 2011

v Provision of financial information related to planning and implementation of our social enterprise program to enable First 5 LA to track the programmatic and fiscal impact of the program

Authorized Signatory Name: (please print)
Authorized Signatory Title:
Signature:
Date:

2011 SOCIAL ENTERPRISE ACADEMY APPLICATION

Please provide the following organizational and financial information for the past 3 years:

FY 2008 / FY 2009 / Current FY (est.)
Operating Expense ($)
Net Operating Income ($) (Operating revenue less operating expenses)
Paid staff in FTE
(1 person full time =
1 FTE)
Number of paid staff (full & part time)

What percentage of annual income from the most recently completed fiscal year came from:

____% Foundations

____% Government (state)

____% Government (federal)

____% Fundraising (individuals, events, etc)

____% Earned income – fee for service, admissions, other

____% Earned income – social enterprise

Please provide brief responses to the following questions.

1. Please describe your organization’s mission, core services and primary programs.

2. Please provide a brief description of your services for the 0-5 population.

3. Does your organization have a social enterprise business or activity? Y N

If yes, describe the business service or product and the current status (in development, active, for how many years, profit-generating, etc). What was the total earned income for the social enterprise activity/ies for the most recent fiscal year? What was the total operating cost?

4. If your organization has an active or nascent earned income program or idea, how much or what kind of research have you done/did you do in developing this program?

5. Please provide a brief explanation of why you and your organization would like to participate in the First 5 LA 2011 Social Enterprise Academy and why you believe that this program will benefit your organization, particularly at this time.

6. Please describe the level of awareness among the Board and staff of social enterprise

earned income. Is there internal support for exploring the concept and practicality

of earned income?

7. Has your organization completed a recent sustainability plan or strategic plan?

First 5 LA Sustainability Project

Other Strategic Planning Process

SOCIAL ENTERPRISE ACADEMY TEAM

Please list the three to five key members of your leadership and/or staff who will actively participate in the Social Enterprise Academy Workshop Series and Showcase. Please include name, title, how long they have been with your organization and a brief description of their role.

Primary Contact/ Team Leader:______

Title (at this organization):______

Mailing Address ______

______

Primary phone number: ______

Primary email address ______

Role/Responsibilities: ______

______