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WEINGART FOUNDATION SMALL GRANT APPLICATION
Instructions
Thank you for your interest in Weingart Foundation's Small Grant Program.
Please read the instructions below before you begin the online application
process. Doing so will help you present a strong proposal and avoid any
unnecessary delays in the completion and consideration of your application.
A. APPLICANT INFORMATION
The IRS tax identification number and legal name of organization should populate
automatically from your account creation. If your organization has a DBA or is recognized
by another name, please provide the name. Enter the primary office address and contact
information for the applicant organization. If fiscally sponsored, please enter year program
founded. If agency operated program(s) prior to legal incorporation, please enter year
program was founded.
B. FISCAL SPONSOR INFORMATION Fill in this section only if your agency has a fiscal
sponsor. Otherwise leave it blank.
A fiscal sponsor is a tax-exempt 501(c)(3) organization that agrees to accept and be
responsible for grant funds on behalf of another organization, which typically does not
have its own 501(c)(3) status or lacks the infrastructure to manage grant funds. The fiscal
sponsor is responsible for the general management of grant funds, which can include
keeping financial records, disbursing funds in accordance with the grant, and fulfilling
reporting requirements.
C. BOARD OF DIRECTORS INFORMATION
Provide requested information for the most recently completed fiscal year. If your agency
is fiscally sponsored, complete this section for the board of your fiscal sponsor.
D. ORGANIZATION INFORMATION
For number of persons served, include only those directly served by the organization. The
figure should represent unduplicated clients served during the past fiscal year.
Mission
Provide the organization's mission statement. If the organization is part of a larger entity
(e.g. affiliate or chapter), briefly describe the governance and financial relationship, if any,
including whether the applicant organization is responsible for raising and managing its
own budget. Example: "As an independent chapter of the national XYZ organization, XYZLA has a local advisory board and full responsibility for raising its own budget at the local
level. The XYZ-National provides programmatic and back office support."
Percentage Low-Income Served
What percentage of those served by the organization as a whole is low-income? Also, briefly
explain how your organization defines low-income (e.g. federal poverty guidelines, eligibility
for the free/reduced-price lunch program, etc.). If agency does not specifically track
demographic information, please provide an estimate as well as a brief explanation of how the
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figure was determined.
Geographic Region Served
Include all regions served by the organization. If agency also works outside of Southern
California (e.g. statewide or nationally), check “Other” and specify the regions served.
Programs and services
Briefly describe the organization’s core programs and services, including main activities,
program length/participant time commitment (if applicable), sites, and program staff
qualifications in general. Example: “Standards-based after-school arts education program
runs at five schools for 16-weeks, with one-hour weekly sessions facilitated by a trained
teaching artist”
Program impact and outcomes
Describe the impact of your organization's core programs and explain how you assess
program effectiveness. Briefly share 1-2 recent examples of information (e.g. outcome
data, client feedback, survey or evaluation results) that demonstrate programmatic
impact. Examples of program impact: (1) Through pre and post testing, X% of participants
demonstrated an increased awareness of basic arts concepts; OR (2) Verbal and written
client feedback indicates that X% of participants report increased knowledge of available
community resources for domestic violence survivors.
For number of persons served, include only those directly served by the organization. If
none, type "no direct services provided." The figure should represent unduplicated clients
served during the most recently completed fiscal year. If exact figures are not available,
provide estimates and denote with an (e).
For number of paid staff, exclude contractors and temporary/seasonal employees.
E. FINANCIAL INFORMATION SUMMARY
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The Foundation recognizes that this section uses accounting terms which may be
unfamiliar. Some applicants have found it helpful to involve an accountant in
completing this section. Please do not hesitate to contact us at the Foundation if
you have questions.
In filling out this section use your financial statements (income
statement/statement of activities and statement of financial position/balance sheet)
for the most recently completed fiscal year for the organization. All figures should
match the numbers in your financial statements.
Round off all figures to the nearest dollar; do not include cents.
Financial Statements
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Audited financial statements for the most recently completed fiscal year are
required of all organizations over five years old and with operating expenses of
$500,000 or more.
Organizations under five years old or those with operating expenses under
$500,000 that do not have an audit must submit an independent review of their
financial statements, completed by a CPA.
Small Grant applicants that cannot meet the financial documentation requirements
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may be eligible for an exemption on a case by case basis upon review of the full
application.
Organizations do not need to specifically request this exemption, and should apply
with unaudited or internal financial statements with the understanding that if a
grant were approved it would be as an exception to policy.
A financial statement is a historical report about the financial condition of an organization.
There are various types of financial statement reports:
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An audit is the highest level of report. It is the examination of a company's financial
statements by an independent public accountant.
A review is a statement that, like an audit, is prepared from an organization's own
data. The CPA provides input on how the information should be presented, verifies
the major items and conducts some basic research.
A compilation is a statement prepared from the organization's own data that had
CPA input for presentation purposes only.
Internal statements are prepared by the organization itself and may come, for
example, from a software program. Internal statements should consist of 1) a
Statement of Activities (also known as an Income and Expense Statement) for the
12-month period that covers the most recently completed fiscal year; and 2) a
Balance Sheet listing assets and liabilities for the most recently completed fiscal
year.
Total Income and Expenses
These numbers should be the same as those in the financial statements you submit. If
your organization incurred an operating deficit (expenses exceeded income), state what
caused the deficit and how it was managed. Examples include use of reserves or
borrowing.
Total Net Assets
These figures should be taken directly from your Statement of Financial Position in your
organization's audited financial statements. If you are using internal statements, this
figure can also be found on your Balance Sheet. Total net assets is also known as total
equity.
Total Long-Term Debt
All debt payable after one year. Do not include in this figure current liabilities, which are
due within one year. Examples of long term debt include mortgage payments.
F. REQUEST INFORMATION
The agency’s overall mission and programs must be strongly aligned with the Foundation’s
funding guidelines and priorities.
Request Description
Provide a brief description of why you are requesting unrestricted support and why it is
needed now. How would unrestricted funding be useful for your organization’s capacity
and effectiveness?
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Total Amount Requested from Weingart Foundation
Specify the amount you are asking the Foundation to consider. Please specify a dollar
amount, rather than giving a range.
The Small Grant Program awards a maximum of $25,000. Within this limit, it is up to agencies
to decide the appropriate request amount based on your project budget and funding plan.
However, please note that due to the high demand for funding, average grant awards range
from $10,000 to $15,000 and will generally not exceed 10% of an agency’s annual operating
budget.
Short and Long-Term Financial Needs
Because the Foundation seeks to support organizational sustainability we are interested in how
your organization specifically plans to support its short and longer term financial needs.
Describe your plan and state as specifically as possible any potential funding sources that have
been identified or secured (for example, through multi-year commitments) for the current and
next fiscal years.
G. Supporting Documents Required
In order to complete your online application to the Weingart Foundation, you must attach
the following document/s for both your agency and its fiscal sponsor (if applicable)
1. Board of directors and/or advisory council list, including members' relevant
professional affiliations
2. Current annual operating budget (projected revenues and expenses for your current
fiscal year) (Required)
3. Financial statements for organization's most recently completed fiscal year. If an
audit, independent review, or compilation is not available, please submit internallyprepared financial statements (income statement and balance sheet). A 990 will not be
accepted in lieu of financial statements
Please note that an application that is missing any of the required supporting
documents is considered incomplete and will not be processed.
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APPLICATION
A. APPLICANT INFORMATION
IRS tax ID number
Year incorporated
Legal name of organization as stated in IRS nonprofit determination letter
Do people know you by a different name?
Also Known As or Doing Business As or Formerly Known As (if applicable)
Address
City
State
Zip/Postal Code
Main phone number
(xxx)xxx-xxxx
Main fax number
(xxx)xxx-xxxx
Website
.
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B. FISCAL SPONSOR INFORMATION (if applicable)
Legal name of organization as stated in IRS nonprofit determination letter
Address
City
State
Zip Code
Telephone #
(xxx)xxx-xxxx
Fax #
(xxx)xxx-xxxx
Website
.
IRS tax ID number
Year incorporated
Name, title and e-mail address of organization's chief staff officer
C. BOARD OF DIRECTORS INFORMATION
If your agency is fiscally sponsored, complete this section for the board of your fiscal
sponsor. Otherwise complete section as it pertains to your board
Number of persons serving on the board
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Number of board meetings held during past fiscal year
Number of directors making personal financial contributions to organization
Total dollar amount personally donated by all Directors to organization
(in whole dollars, do not use $ sign)
Total dollar amount raised by all Directors on behalf of the organization
(in whole dollars, do not use $ sign)
D. ORGANIZATION INFORMATION
Mission statement
Please provide the organization's mission statement. If the organization is part of a larger entity (e.g. affiliate or
chapter), briefly describe the governance and financial relationship, if any, including whether the applicant organization
is responsible for raising its own budget. (200 word maximum)
Percentage low-income served
What percentage of those served by the organization as a whole is low-income? Also, please briefly explain how your
organization defines low-income (e.g. federal poverty guidelines, eligibility for the free/reduced-price lunch program,
etc.). If agency does not specifically track demographic information, please provide an estimate as well as a brief
explanation of how the figure was determined. (150 word maximum)
Geographic region served
Include all regions served by the organization. If agency also works outside of Southern California (e.g. statewide or
nationally), also check “Other” and specify other regions served.
Programs and services
Briefly describe the organization’s core programs and services, including main activities, program length/participant time
commitment (if applicable), sites, and program staff qualifications in general. (350 word maximum)
Program impact and outcomes
Describe the impact of your organization's core programs and explain how you assess program effectiveness. Briefly
share 1-2 recent examples of information (e.g. outcome data, client feedback, survey or evaluation results) that
demonstrate programmatic impact. (150 word maximum)
Number of unduplicated children served during the past fiscal year (0-17 years)
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Number of unduplicated adults served during the past fiscal year (18 years and older)
Number of full-time paid staff
Number of part-time paid staff
Number of volunteers (excluding board)
E. FINANCIAL INFORMATION (Please review the Foundation's financial documentation
requirements found in the application instructions under section E)
Financial statements
Please report on most recently completed fiscal year, which ended (MO/DY/YEAR):
Total income
Based on the last fiscal year (in whole dollars, do not use $ sign)
Total expenses
Based on last fiscal year (in whole dollars, do not use $ sign)
If expenses exceeded income for the year, explain reason
How was the deficit financed?
Total net assets
(in whole dollars, do not use $ sign)
Total long-term debt
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(in whole dollars, do not use $ sign)
Request Information
F. UNRESTRICTED OPERATING SUPPORT REQUEST INFORMATION
Request description
Provide a brief description of why you are requesting unrestricted operating support and why it is needed now. How
would receiving unrestricted operating support impact your organization? (450 word maximum)
Total amount requested from Weingart Foundation
(in whole dollars, do not use $ sign)
How does your organization specifically plan to support its short and longer term financial
needs? (200 word maximum)
Contact Information
CONTACT INFORMATION FOR THE PERSON SUBMITTING/PREPARING THIS
APPLICATION
Primary contact for this application
Prefix (Mr., Mrs., Ms., etc.)
First name
Last name
Suffix (M.D., Ph.D., etc.)
Title
Address
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City
State
Zip code
E-mail
Phone # (xxx) xxx-xxxx
Extension
Fax # (xxx) xxx-xxxx
Organization's Chief Staff Officer (e.g.: CEO, COO, President, or Executive Director)
Prefix (Mr., Mrs., Ms., etc.)
First name
Last name
Suffix (M.D., Ph.D., etc.)
Title
Address
City
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State
Zip code
E-mail address
Phone # (xxx) xxx-xxxx
Extension
Fax # (xxx) xxx-xxxx
Certification/Authorization
Submission of an application indicates your organization's permission for Weingart Foundation to make an independent
inquiry about your organization, Board, staff and others with whom you are affiliated. I certify that I am authorized to
submit this application on behalf of the requesting organization and attest to the accuracy of the information.
First name
Last name
Title
G. Supporting Documents Required
In order to complete your online application to Weingart Foundation, you must attach the
following documents. If your agency is fiscally sponsored or is a program of a national or
statewide organization, please include attachments for your agency/program and your fiscal
sponsor/ parent organization where applicable.
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Board of directors list (for fiscally-sponsored agencies or programs of national/statewide
organizations, please also upload the advisory council roster)
Current annual operating budget (revenues and expenses for fiscal year)
Financial statements for organization’s most recently completed fiscal year. If an audit,
independent review, or compilation is not available, please submit internally-prepared
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financial statements (income statement and balance sheet). A 990 will not be accepted in
lieu of financial statements.