For reference only: Applications must be submitted online using the link on Page 1.
Wayne County Community Endowment Advisory Committee
The Community Foundation
500 East Avenue
Rochester, NY 14607
www.racf.org
The Wayne County Community Endowment Advisory Committee is a volunteer panel of communityminded Wayne County residents who are knowledgeable about community needs and dedicated to
improving the quality of life in Wayne County.
The Wayne County Community Endowment Advisory Committee, on behalf of Rochester Area Community
Foundation, is accepting applications from charitable organizations whose efforts strive to improve the
health, well-being, and quality of life for residents in Wayne County, especially youth and seniors.
Applications are also encouraged from charitable organizations in Wayne County whose efforts strive to: (1)
promote the literacy of ethnic and minority youth and (2) provide services to youth in Clyde, New York.
Criteria and eligibility guidelines:
 Applicants must be a 501(c)(3) organization or sponsored by a charitable, nonprofit organization. Funds
must be used in Wayne County;
 Services and funds must benefit Wayne County residents;
 Applications, especially those for ongoing projects, must demonstrate that the project can be sustained;
 Applicants must be able to measure the project’s success and its results in the community;
 Applications should focus on important community quality of life issues and needs;
 Applications should focus on new or expanded projects, not continued support of on-going projects.
 Organizations are urged to participate in one of a variety of communications programs through the
Ad Council of Rochester. Contact Katelyn at KRyan@adcouncilroch.org or (585) 442-0200 x204 for
more information. (75%-100% of the cost of participation is underwritten by the Bullis Fund.)
Grants will NOT support:
 Individual Wayne County residents;
 Debt reduction;
 Religious activities, although non-religious activities provided through religious institutions will be
considered; or
 Fundraising campaigns, such as endowment campaigns.
Grant size:
Grant awards will typically range between $1,000 and $5,000. Grants under $1,000 will also be considered.
Service providers may be granted up to $5,000 per calendar year.
Proposal due date:
Applications must be submitted online by 5pm on Friday, May 29, 2015. To begin a new online application,
click here.
Contact:
Lori Banning
The Community Foundation
500 East Avenue
Rochester, NY 14607
(585) 341-4357
lbanning@racf.org
For reference only: Applications must be submitted online using the link on Page 1.
How to submit an application:
1.
Complete the enclosed Applicant Organization Information Sheet for the organization submitting
the request and the Program/Project Budget Sheet for the proposed project for which you are
seeking funding. Provide a brief budget narrative to explain the budget. Do not staple documents or
submit items in folders or binders.
2.
Answer the following questions (A - F) as specifically as possible in four typed pages or less.
Do not repeat information from one section to another:
A.
Need and Demand
1.
2.
B.
Outcomes
1.
2.
3.
C.
Describe what you propose to do, how you will do it, and the resources that you will
access or use.
Organizational Capacity
1.
2.
E.
What do you expect to achieve through this project?
How will you measure your progress and determine if you have reached your
goals/desired outcomes?
When will you achieve the outcomes?
Project Description, Resources, & Activities
1.
D.
Summarize the need for your proposed project. Cite any research documenting the
need, if possible.
Summarize customer demand for your proposed project. (Waiting lists, unfulfilled
requests, etc.)
What is your organization’s mission and how does this project relate to it?
Describe experiences you have in implementing similar projects. If your organization
has no similar experiences, please explain why you are qualified for this undertaking.
Links with other agencies
1.
Provide the names and roles of collaborative partners, if any. Include letters of
support if relevant.
F. Future
1.
2.
3.
Provide the following four items with your completed application:
1.
2.
3.
4.
4.
What is the future of this project beyond the grant period?
If it is to continue beyond the grant period, how will you support this project?
One copy of the IRS determination letter advising that your organization is exempt
from taxes under Section 501(c)(3) of the IRS code and that the organization is not a
private foundation as defined in Section 509(a);
A list of the organization’s Board of Directors with their affiliations;
A financial summary of your organization’s most recently completed fiscal year,
including the original budget and actual revenue and expenses for that year; and
An Annual Report.
Applications must be submitted online by 5pm on Friday, May 29, 2015.
For reference only: Applications must be submitted online using the link on Page 1.
WAYNE COUNTY COMMUNITY ENDOWMENT ADVISORY COMMITTEE of
ROCHESTER AREA COMMUNITY FOUNDATION
ORGANIZATION INFORMATION SHEET
Name & address of applicant organization:
Is the name at the left the same as it appears on the
IRS 501(c)(3) Letter of Determination?
yes
no
If not, explain:
Phone Number:
Fax Number:
E-mail:
Chief Executive Name:
Chief Executive Title:
9-digit Federal Employer ID #:
Year organization incorporated:
Name of this program or project:
Program/project contact person:
Name:
For current fiscal year:
Organization’s total budgeted revenue:
Organization’s total budgeted expenses:
Fiscal year:
to
Revenue Sources:
% government
(city, county, state,
federal)
% United Way
% membership
% fees
% grants
% investment income
% fundraising (e.g.
events, gifts, bequests, etc.)
Information for This Request
List other potential and actual sources of support put an “*” by those committed, noting any matching
fund requirements.
Amount
Funder
Phone Number:
Email:
Total cost of this effort:
Amount requested from this funder:
Type:
Program/Project
General Support
Other (describe)
Date funds needed by:
Date by which funds will be spent:
List major funders of program/project for past two
years if applicable:
Amount
Funder
For reference only: Applications must be submitted online using the link on Page 1.
WAYNE COUNTY COMMUNITY ENDOWMENT ADVISORY COMMITTEE
ROCHESTER AREA COMMUNITY FOUNDATION
PROGRAM / PROJECT BUDGET SHEET
Provide the requested information for the program or project for which you are seeking this grant.
SUPPORT / REVENUE
Total Anticipated
Support/Revenue
Requested grant per this application
Fundraising or special event revenue
Other foundation or corporate grants
Government grants or contracts
United Way support
Other contributions
Fees for service
Sales revenue
Membership dues
Investment income
TOTAL Support/Revenue
Double-click the table to
activate Excel features
and enter information.
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
EXPENSES
Total Expenses for
Program/Project
Salaries
Fringe benefits
Professional fees (contracts, consultants)
Evaluation
Training
Travel/meeting expenses
Occupancy
Phone, fax, information technology
Printing/postage
Supplies (consumable)
Equipment
Subtotal: Direct Expenses
Proration: General/Management Overhead
TOTAL Expenses
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Expenses to be
Covered by
Requested Grant
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
For reference only: Applications must be submitted online using the link on Page 1.
WAYNE COUNTY COMMUNITY ENDOWMENT ADVISORY COMMITTEE
ROCHESTER AREA COMMUNITY FOUNDATION
BUDGET NARRATIVE
Include a brief Budget Narrative of no more than one page to explain your budget.
For reference only: Applications must be submitted online using the link on Page 1.
WAYNE COUNTY COMMUNITY ENDOWMENT ADVISORY COMMITTEE
ROCHESTER AREA COMMUNITY FOUNDATION
EXECUTIVE SUMMARY
Prepare a one-page Executive Summary in bulleted form as a brief synopsis of your request.
Organization Name:
Project Activity Name:
One Sentence Activity Description:
Need Addressed:
Target Population:
Goals/Objectives of Services:
Measurable Project Outcomes:
Amount Requested:
Total Cost of Project/Program:
Fit with Funding Interest:
Project's Main Activities:
ACTIVITY
(what will be done?)
TIMELINE
(when?) start mo/y - end
mo/yr
PERSON(S)
RESPONSIBLE
(who will do it?)