APT Charities Grant Application
APT Charities seeks to fund outstanding organizations in their pursuit of using data to make better
decisions and to increase their impact.
APT Charities funds two types of awards:
 Grant ($10-15k)
o Intended for organizations with some experience using data collection and analysis to
inform decision making
 Stimulus Award ($5k)
o Intended for organizations with little or no experience in data-driven decision making
who would like to invest in collecting, validating, or analyzing data
At this time, APT Charities is accepting applications from organizations with 501(c)(3) status, pending
501(c)(3) status, and global organizations. APT Charities does not support political organizations or
religious organizations aimed at propagating a particular faith or creed. Secular programs (such as soup
kitchens, shelters, job banks, etc.) sponsored by religious organizations are eligible for a Grant or
Stimulus Award.
The deadline for submission is October 30th, 2015. Online applications will be reviewed within four
weeks of the submission deadline. To inform the final selection, selected organizations will be invited to
interview with APT Charities members and to submit an operating budget and proof of nonprofit status.
Applications may be submitted the following ways:
 Email application form to grants@aptcharities.org
 Print and mail application form to the following address (postmarked by October 30, 2015):
APT Charities Grant Applications
901 N Stuart Street
Suite 1000
Arlington VA 22203, USA
Please direct any questions to the APT Charities applications committee: grants@aptcharities.org
Section 1: Background Information
Organization
Name: _________________________________________________________________________
Address: _______________________________________________________________________
Contact Person
Name: _________________________________________________________________________
Role: __________________________________________________________________________
Email address: __________________________________________________________________
Phone Number: _________________________________________________________________
Mission & Purpose
Please provide a brief summary of your organization’s mission and key programs. (Please limit response
to 250 words)
Type of Award
Please select the type of award your organization is requesting. If you an unsure which type of award
would be most appropriate for your organization, please contact the APT Charities Grants Committee
(grants@aptcharities.org).

Grant ($10-15k)
o Intended for organizations with some experience with using data collection and analysis
to inform decision making
 Stimulus Award ($5k)
o Intended for organizations with little or no experience in data-driven decision making
who would like to invest in collecting, validating, or using data, and building analytic
capabilities
Communication
If selected as a recipient of an APT Charities Grant or Stimulus Award, would your organization agree to
participate in a press release? (Note: Your organization’s eligibility is not contingent upon agreement to
a press release.)
YES or NO
Section 2: Impact Logic Model
Please prepare an impact logic model for your proposed investment (750 words maximum; See attached
page for template). For more information about logic models, please see the Nonprofit Resource
Center.
Section 3: Project Budget
Total Funds requested: ______________
Please attach a budget for this project, including revenue from other sources and key expenses. Refer to
the example project budget.
Section 4: Additional Information
Documentation
If your organization is selected to continue in the APT Charities grant process, the following documents
will be requested:
- Organization’s operating budget with total revenues (including sources of funding) and expenses
for (1) last fiscal year and (2) current fiscal year
- Most recent audited financial statements if annual budget is more than $500K
- If the organization has been the subject of an IRS audit or the nonprofit status has been
challenged by any entity in the last 24 months, attach an explanation and the response
- If the organization is applying for the first time, include a copy of the current IRS determination
letter indicating tax-exempt status under section 501(c)(3) or, if pending, an explanation of
application status
Will your organization be able to provide all of the requested information? : YES or NO
If not, please explain why:
Additional Notes
Let us know if there is any additional information we should know about your organization (please limit
response to 100 words)
Signatures
Please provide the following signatures:
Project Director / Date: _________________________________________________________________
Executive Director / Date: _______________________________________________________________
Impact Logic Model
Problem Statement: What is the problem you are solving (internal or external)?
Project Goal(s): What is the goal of the program?
Assumptions & External Factors: What rationales and assumptions are your model based on?
Inputs
What resources will you invest?
Activities
What activities will you do exactly?
Outputs
What outputs do you expect?
Outcomes
How will these outputs affect
outcomes?
How do these outcomes meet your
goal?