United Way Wayne County

Community Impact Funding Opportunity Overview

HUMAN SERVICE not-for-profit agencies serving Wayne County residents are invited to submit an application for competitive funding consideration as a Community Impact Partner Agency. United Way believes that the health, education and economic mobility of Wayne County residents are critical for the community to thrive. We are thrilled to offer an opportunity for programs who focus on one of these three areas to become funded partner organizations. Community Impact Partner Agencies will address the highest priority needs identified by the community members and stakeholders of Wayne County.

COMMUNITY IMPACT GRANT AREAS

EDUCATION - Foster learning programs that help youth to achieve developmental milestones through the provision of learning and enrichment in out-of-school time. Programs will focus on the development of self-esteem and healthy choices, and/or career preparation to support high school graduation and position youth for future success.

HEALTH - Improve health by supporting programs that help meet basic needs, foster positive and sustaining social and emotional connections throughout an individual's lifespan, and heal people from trauma.

ECONOMIC MOBILITY - Provide access to the necessary tools and opportunities people need to increase income, build wealth and improve financial stability including but not limited to the development of soft skills and financial literacy.

Application Requirements

SUBMISSION:

You will be requested to upload all supporting documents in the Attachments section at the end of this application.
Before filling out the application, please have all documents requested below available for attachment.
Please prepare to complete grant application in one session, through submission, as the form will not save your progress.
You will receive an email verifying your application was submitted.

GRANT YEAR: Aug. 2021 through July 2022 with an additional year grant renewal opportunity based on positive outcome reporting and available funding. Submission is not a guarantee of funding, only agencies chosen for further funding consideration will be contacted in June. Phone: 315-331-2773.

DUE DATE: Applications will be accepted until 3:00pm on Monday May 3, 2021

Please email questions to: Newark@uwrochester.org or call (315) 331-2773. We strive to answer all questions within 24 hours of receipt.

2021-22 Funding Application (Must complete all sections)2021-22 United Way Wayne County Budget Form (All three tabs) - Click here to access budget form - please upload completed budget form below in the attachment sectionMost recent fiscal year-end financial report
List of Current Volunteer Board of Directors or Advisory Committee MembersCover Page detailing program for which you are requesting funding

Agency Information

Agency Name:

Executive Director/Board Chair/Other:

Address:

City:

Zip Code:

Phone:

Cell:

Email:

Website:

Federal ID #:

Charities Registration #:

Program Information

Program Title:

Program Director:

Program Address:

Program City:

Program Zip Code:

Program Phone:

Program Cell:

Email:

Total Program Budget:

United Way Wayne County Funds Requested:

Fiscal Contact Information

Contact Name, Title:

Email:

Phone:

Cell:

Program Summary

Program Sites

Site Type 1 :

Site Name 1:

Site Address 1:

Site Type 2:

Site Name 2:

Site Address 2:

Program Attendance/Number of People Served

(Please use whole numbers, & pro-rate yearly amounts based on past 8 months.)

Total Program Enrollment:

Proj. Daily Attendance:

Identifying Gender of Participants:

Male:

Female:

Other:

Ethnicity of Participants

White:

Black or African American:

Hispanic or Latino:

American Indian or Alaskan Native:

Asian:

Native Hawiian or other Pacific Islander:

Two or more races:

Age of Participants

0-4:

5-9:

10-14:

15-17:

18-20:

21-55:

Over 55:

Community Impact Focus Area Applying For (Choose One)

Focus Area : HEALTH

Description:

Grants will be awarded for programs aiding families and individuals in meeting their basic needs, supplying a safe place to live and offering a positive impact on their social, emotional and nutritional health.

Requested Funding Amount for HEALTH:

Focus Area: EDUCATION

Description:

Grants will be awarded to programs that Foster learning programs that help youth to; Achieve developmental milestones by filling their out-of-school time with learning and enrichment; Develop strong self-esteem and make healthy choices; Explore career preparation and improve high school graduation for future success.

Requested Funding Amount for EDUCATION:

Focus Area: ECONOMIC MOBILITY

Description:
Grants will be awarded for programs supplying individuals with the necessary tools to increase income, build wealth and improve financial stability.

Requested Funding Amount for ECONOMIC MOBILITY:

Program Report Form

Statement of Problem Being Addressed:

Program Goal:

Community Impact Specific Focus Area:

Target Population:

Goal Description:

Evaluation Plan

Evaluation Plan:

Projected Outcome Objectives:

Performance Standard:

Outcome Measurement:

United Way Support

Describe how funds would be used in 2021-22

Budget (Please Click Here to fill out the common budget form for each program funded by United Way - please fill out all three tabs.)

Alternative Plans (If program is not funded):

Organization

Executive Director

Page 5

Certify

2021-22 Funding Application

United Way Wayne County

Agency Information

The individual submitting this proposal on behalf of his or her agency, certifies by signing below that

He or she has read and understood the full Request for Proposal sited above; and
He or she is duly authorized to submit the proposal on behalf of the agency noted above.

Checking this box, certifies the individual submitting this proposal is submitting on behalf of the agency

Type First and Last Name below:

Attachments

Attach budget form

Attach fiscal report

Attach board roster

Attach cover page