Proposal Form
Supplements to Youth Academy and Community Conversations
Organization Name:
Organization Point of Contact:
Email address:
Phone number:
Address:
List your organization’s most recent federal grant; funding entity; and year:
Tax Identification Number:
Web address (if available):
Copy of most recent audit (attach)
Answers to the following questions:
1. Describe your organization’s experience with mentoring programs, the mentoring model
your organization would use, and how your organization would oversee mentoring to 2030 10th and 11th grade youth throughout the state. Describe how mentors will be
recruited, trained, and supported throughout the year. What outcomes do you expect to
achieve from the mentoring? (up to 500 words)
2. Describe how your organization would coordinate community conversations and the
local organizations or partners that would be engaged in planning and holding the
events. Explicitly state how these organizations or partners are connected to the tribes,
tribal councils, and local schools. How would your organization promote and advertise
the event? What native communities and other communities with significant native
populations would host the community conversations? (up to 500 words)
3. How will your organization collaborate and engage the REAs in community
conversations and future activities? What data and information will you provide
appropriate REAs on an as-needed basis? How will you communicate with REAs? How
will you gather information and knowledge about the existing relationships REAs have in
the targeted communities? How will your organization and its partners build relationships
with individual REAs serving the targeted communities? (Note: Communications and
level of involvement will vary by REA.) (up to 500 words)
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4. Describe how your organization will collect data and information to report on the desired
outcomes and other progress. Describe any additional measures your organization
would like to track, including the baseline data. Describe how this information and data
will drive program activities and how this information will be shared with FHI 360 and the
REAs. (Note: FHI 360 will require regular reporting.) . (up to 500 words)
5. Describe your organization’s experience working across the state with school districts,
students, community leaders, and organizations/partners in communities with a large
native population. (up to 500 words)
6. Describe the staffing model proposed to implement the program, including specific staff
roles. If possible, please name the project director and the person who is coordinating
mentoring activities. (up to 500 words)
7. Provide three references and contact information.
8. Provide a budget and budget narrative using the following template. Note: There do not
need to be expenses in each category. FHI 360 will only accept indirect costs if the
organization has a Negotiated Indirect Cost Rate Agreement or a rate determined by an
external auditor or state-government entity. The budget should not exceed $125,000 for
a 10 month period. The funding will not support capital projects or purchase of
equipment. If your program model would require equipment purchases, please explain
why.
SUCCEED 2020
Proposal to FHI360
Period of Performance: 09/01/15-06/30/16
09/01/15 - 06/30/16
10 Months
Rate Unit
1. PERSONNEL COST
Units
Total
Position/title
/hour
-
Subtotal 1.1
1.2. Fringe Benefits
Subtotal 1.2
TOTAL PERSONNEL COSTS
2. Travel & Transportation
Location
2
TOTAL TRAVEL COSTS
3. Consultants
rate/unit
TOTAL CONSULTANTS
4. Other Direct Costs
TOTAL OTHER DIRECT COSTS
5. Grants
Grantee
rate
TOTAL GRANTS
6. INDIRECT/COSTS
TOTAL INDIRECT COST
TOTAL PROPOSED
BUDGET
FHI 360 and its partners will not review any other information provided in the application.
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Submission instructions and timeline
Applications should be submitted to Stephanie Davison at sdavison@fhi360.org by 11:59 pm
Eastern Standard Time on July 24, 2015. FHI 360 and its partners anticipate selecting an
applicant by August 10, 2015 with work beginning on or before September 1, 2015.
Applicants will be scored with the following point values:
•
•
•
•
•
•
•
Ability to implement a statewide mentoring program – 20 points
Ability to coordinate community conversations with local community partners – 20 points
Ability to engage REAs in a meaningful way - 15
Ability to measure projected outcomes of the project – 15 points
Qualified and experienced staff – 10 points
Price reasonableness/budget – 10 points
Organizational capacity to carry out program – 10 points
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