Good Sports Application
Organization:
Sport:
First Name:
Last Name:
Title:
Billing Address (personal/organization):
Phone:
Alternate Phone:
Email:
Web Site:
Mailing/Shipping Address:
Section 2
Season Start Date (month):
Season End Date (month):
Number of youth in program:
How many participated last year?:
Number of times per week program meets:
Number of games/matches played per week in season:
What time of day does your program meet?
Demographics of youth in Program (please provide number for each category)
Asian
African American
Latino(a)
White/Caucasian
Other Populations
Totals
Age of Youth / Male / Female / Total
5-7
8-10
11-13
14-16
17-18
Other
Totals
Number of youth with disabilities you serve: 0
Please list the top three towns/neighborhoods you serve:
Section 3
How many years has this specific program been in existence:
Is there a fee to participate: yes/no?
How much per child per season:
Is the cost subsidized for any athlete:
What is the organization's budget for the current year:
If part of a broader organization, what is the program budget for the specific sport for which you are applying? (i.e. what money is specifically allocated to the basketball program):
Of the program budget, what percent of the budget goes to equipment each year:
Do you pay umpire/referee fees:
What organization or resources do you use to get umpires/referees?
Please list the number of staff next to each of the following?
Full-time (paid):
Part-time (paid):
Volunteers:
Does your organization have a Board of Directors:
Does your organization have its 501(c) 3 status:
Which of the following would you identify as needs for your youth sports league/program? (Choose a number between 1 and 4, with 4 being the biggest need)
Organizational support (board, leadership, and program development; strategic planning): / 3
Equipment: / 4
Working collaboratively with other programs and organizations: / 1
Administration/organization support (i.e. technology, office equipment, supplies, communication, etc.): / 3
Recruitment, training and retention of staff: / 2
Recruitment, retention and training of volunteers (including coaches education): / 1
Transportation: / 2
Assessment and outcomes measurement: / 3
Professional liability insurance, CORI/SORI checks or other legal questions: / 3
Engaging and working with parents: / 2
Permitting, fields and facilities: / 4
Fundraising support, sponsorships, marketing and PR: / 3
Is there a selection/tryout process for youth participating in your program? no
Is any equipment provided by the organization given to the youth to keep, or does it stay with the organization? Please explain.
What percentage of your equipment each year needs to be replaced?
What percentage of your equipment each year is lost, stolen, or not returned?
Where do you store your equipment during the season? Is this a locked facility? Please explain.
Where do you store your equipment in the off season? Is this a locked facility? Please explain.
Do you require your coaches/ staff to be CPR certified?
Are your coaches/ staff involved in regular safety training?
Does your program have access to an AED/ defibrillator at all games/ practices?
Does your organization combat childhood obesity? (yes/no)
If yes, what programs do you have in place to track/monitor progress?
Section 5
In order to allow us to understand your equipment priorities, please explain out of the above mentioned items what you consider your major equipment, apparel, and footwear needs (i.e. will not be coming from another source) for the upcoming season?
If granted, how would the equipment you request be used? What goals or initiatives will it support? How will this donation be used to increase participation?
Please briefly explain the history of your organization and the specific program for which you have applied.
What impact would this equipment donation make for your program? Please be specific.
What will happen if we are unable to support your organization?
Section 6
BUDGET
Grants
Participant Fees
Sponsorship
Product or Service Sales
Special Events
Other
Total Revenue:
Expenses
Equipment
Facilities
Referee/Umpire Fees
Uniforms
Staff (includes part-time staff and coaches)
League Fees
Transportation
Insurance
Other
Total Expenses:
Section 7
Which of the following life skills/education components (not including your sports programming) does your organization provide?
Leadership Development
Character Building
Please tell us briefly how you found out about Good Sports: