2017-18 Justice Grant Application

COVER SHEET

______
LEGAL NAME OF ORGANIZATION

______
STREET ADDRESS

______( )______-______( )______-______
CITY/STATE/ZIP TELEPHONE FAX

______
CONTACT PERSON TITLE PHONE NUMBER

IS YOUR ORGANIZATION AN IRS 501(C)(3) NOT-FOR-PROFIT? YES NO

IF NO, NAME OF FISCAL AGENT (FISCAL SPONSOR): ______

IF NO, IS YOUR ORGANIZATION A PUBLIC AGENCY? YES NO

REQUEST SUMMARY

TOTAL REQUEST: $______

PREVIOUS PAX CHRISTI GRANTS

HAVE YOU EVER RECEIVED A GRANT FROM PAX CHRISTI? YESNOYEAR(S): ______

AMOUNT RECEIVED MOST RECENTLY: $______YEAR: ______

Please submit your completed Cover Sheet and Application Narrative no later than January 19, 2018 to:

Please provide the following information in the given order. Limit the narrative to four pages or less.

ORGANIZATION INFORMATION

  1. BRIEF SUMMARY OF YOUR ORGANIZATION’S HISTORY AND THE POPULATION SERVED THROUGH PROGRAMMING.
  1. ORGANIZATION’S MISSION AND GOALS.
  1. DESCRIBE YOUR ORGANIZATION’S CURRENT PROGRAMS AND ACTIVITIES (specific to the population that grant funding is sought for)

PURPOSE OF GRANT

  1. WHAT SPECIFIC SOCIAL JUSTICE ISSUE OR NEED DOES YOUR GRANT PROPOSAL ADDRESS?
  1. WHAT COMMUNITY/POPULATION AND GEOGRAPHIC AREA DOES THE GRANT YOUR PROPOSAL ADDRESS?
  1. FOR WHAT SPECIFIC ACTIVITIES/PROJECT NEEDS DO YOU SEEK GRANT FUNDING?
  1. DESCRIBE YOUR GOAL(S) AND EXPECTED OUTCOMES FOR THESE ACTIVITIES/PROJECT.
  1. DESCRIBE THE ACTIONS THAT WILL ACCOMPLISH YOUR GOAL(S).
  1. DESCRIBE THE ACTIONS YOUR ORGANIZATION WILL TAKE TO BUILD RELATIONSHIP WITH PAX CHRISTI.

IMPACT OF ACTIVITIES

HOW DO THE PROPOSED ACTIVITIES/PROJECT (that you seek funding for) BRING ABOUT LONG-TERM CHANGE IN STRUCTURES, INSTITUTIONS, OR PEOPLE’S LIVES? HOW MANY PEOPLE DOES YOUR ORGANIZATION SERVE?

EVALUATION

BY WHAT MEAN WILL YOU MEASURE THE EFFECTIVENESS OF YOUR ACTIVITIES/PROJECT?

INCOME SOURCES FOR ORGANIZATION

  1. TOTAL ANNUAL ORGANIZATION BUDGET: $______
  2. TOTAL ANNUAL INCOME FOR PROJECT/PROGRAMMING RELATED TO GRANT PROPOSAL: $______
  1. INDICATE, BY PERCENTAGES, YOUR INCOME SOURCES:

Government grants or contracts:______%

Foundations______%

Corporations______%

United Way or other campaigns______%

Churches or religious organizations______%

Individual contributions______%

Fundraising events______%

Membership/Earned income______%

Other______%

(specify) ______

  1. WHAT PERCENTAGE OF INCOME (or budget) IS SPENT ON THE FOLLOWING:

Administration______%

Fundraising______%

Program Services______%

BUDGET

PLEASE SUMMARIZE, AS ACCURATELY AS POSSIBLE, THE BUDGET FOR THE ACTIVITIES/PROJECT YOU ARE REQUESTING FUNDING FOR.

Salaries and benefits$______

Consulting and contracted services$______

(Specify) ______

Office supplies, postage, printing$______

Activities/Project materials$______

(Specify) ______

Other activities/project expenses$______

(Specify) ______

TOTAL EXPENSES$______

ATTACHMENTS

One Copy of Each

FINANCIAL STATEMENTS FROM YOUR MOST RECENTLY COMPLETED FISCAL YEAR, WHETHER AUDITED OR UNAUDITED.

BROCHURES OR LITERATURE THAT DESCRIBE YOUR ORGANIZATION.

IRS 501(C)(3) LETTER.

ROSTER OF BOARD MEMBERS AND THEIR AFFILIATIONS.

LIST OF KEY STAFF AND THEIR QUALIFICATIONS.

LIST OF CURRENT GRANTORS, CONTRACTING AGENCIES AND CURRENT REQUESTS.