Letter of Intent Application
Thank you for taking the time to consider submitting a Letter of Intent Application. This is the
first step in the process to apply for a TPC grant. Please keep in mind the following deadlines
and key dates:
Sep 25, 2015
Letter of Intent (LOI) is due by 5:00 pm EST
Sep 28, 2015
Organizations submitting an LOI are notified by TPC that
the LOI has been received
Sep 28 to Nov 25, 2015
LOIs are reviewed
Nov 30, 2015
Applicants are notified as to whether or not they have
advanced to the Full Proposal stage
Instructions for submitting your application
The Letter of Intent Application Form consists of three steps. Please complete each of these
steps in their entirety. When completed:
1. Save your completed application form and additional financial documents as one PDF file.
2. E-mail your application in PDF form to: connect@thephilanthropyconnection.org by
5:00 pm Friday, September 25, 2015:
We look forward to reading your application!
Step 1
Determine whether your organization meets TPC’s classification of either an emerging or a
mid-stage organization. Check the box appropriate to your organization. If your organization is
under 2 years old or over 30 years old, the organization is not eligible for a TPC grant for the
2016-2017 funding cycle.
☐
Emerging organizations: These are organizations between 2 and 7 years old. Age is
calculated from the year the organization received IRS 501(c)(3) status or signed a
Fiscal Sponsor agreement). For the upcoming funding cycle, this would be between
2008 and 2013.
☐
Mid-stage organizations: These are organizations between 8 and 30 years old. Age is
calculated from the year the organization received IRS 501(c)(3) status or signed a
Fiscal Sponsor agreement. For the upcoming funding cycle, this would be between 1985
and 2007.
Step 2
The following additional criteria must be met in order to apply for a TPC Grant. Please review
the following, answering, “yes” to each question and checking off each box. If you are unable to
answer “yes” to all questions, then your organization does not meet TPC grant criteria and you
should not submit this application.
☐
Our organization’s annual revenue is between $100,000 and $2 million.
The annual revenue of an organization is the Total Revenue reported on the first page of
the most recent 990/990EZ or certified in a letter from the Fiscal Sponsor.
☐
Our organization addresses the negative impact of at least one of the following:
 Poverty
 Income disparities
 Employment disparities
 Educational disparities
 Health and wellness disparities
 Social bias (gender, ethnic, and/or racial).
☐
Our organization is located within the I-495 loop in Massachusetts or in one of the
following towns:
 From the north: Amesbury, Haverhill, Methuen, Lawrence, Lowell
 From the west: Maynard, Hudson, Marlborough, Milford, Franklin
 From the south: Towns north of the intersection of I-495 and Rt. 25 (this does not
include Cape Cod).
☐
Our organization is a 501(c)(3) non-profit or we have a Fiscal Sponsor.
☐
Our organization is not a religious, political, international, or C4 advocacy organization.
☐
Our organization is not a national organization with a local or state chapter.
☐
Our organization is not requesting funding to support a capital campaign.
☐
Our organization is not a hospital program (e.g., centers/departments/units within a
hospital).
☐
We have read The Philanthropy Connection’s “Guidelines for Applying for a Grant.”
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Step 3
Please complete the following application. Please use 11pt font.
Organization Name:
Date:
Federal Tax ID #:
Year organization received IRS 501(c)(3)
status or signed a Fiscal Sponsor
agreement:
Organization Address:
Website Address:
Executive Director:
Years in
operation:
Annual Revenue (as
reported on the most
recent 990/990EZ or
Fiscal Sponsor letter):
Contact person for grants, including name, phone, and e-mail:
Indicate categories that identify the
disparities addressed in your organization’s
mission (check all that apply):
☐ Poverty
☐ Income
☐ Employment
☐ Education
☐ Health and wellness
☐ Gender, ethnic, and/or racial bias
Indicate category(s) for which you are
requesting funding (check all that apply):
☐ New program
☐ Expansion of existing program
☐ Tangible goods that help the
organization support a program (e.g.,
van, cameras, computers, etc.)
☐ Operations
☐ Organizational Infrastructure, (e.g.,
program evaluation, development,
business planning, marketing and
communications, etc.)
Does your organization have a Fiscal Sponsor?
☐ Yes (If yes, please complete the Fiscal Sponsor Information attachment.)
☐ No
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1. Describe your organization’s mission and goals, including a description of the
needs of the population served by your organization (limit 300 words).
2. Describe how your organization’s specific programs address the needs of the
population served (limit 300 words).
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3. Describe how your organization plans to use The Philanthropy Connection funds
(limit 450 words).
4. Describe how you will determine whether or not TPC funds have made a
difference in your organization and/or the individuals receiving services (limit 150
words).
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5. Describe how the proposed funding request fits with The Philanthropy
Connection’s mission (limit 150 words).
Financial documents required for the LOI
Organizations must include the following with their application:


501(c)(3) status letter or Fiscal Sponsor agreement letter
First page of the most recent 990/990 EZ or letter from the Fiscal Sponsor certifying the
applicant’s revenue, including only that which would be reported on the Total Revenue line
of a 990/990 EZ
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Fiscal Sponsor Information
If your organization has a Fiscal Sponsor, please complete this form.
Organization Name:
Date Sponsorship Began:
1. What is the name of the Fiscal Sponsor and what is the organizational relationship
(e.g., structural and/or governance ties, benefits and privileges, changes in the
relationship over time, legal and fiduciary responsibility, etc.)
2. Do you receive financial support from this organization? If so, please disclose:
a) Amount of support:
b) What percentage is this of your budget?
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