Fund for Delaware Collaboration Grant Application

Thank you for your interest in the Fund for Delaware Collaboration ("Collaboration Fund"). Please feel free to reach out to us at any time at delaware@seachangecap.org or (844) 869-7842 to discuss your situation directly before completing the form.

Please note:

We take confidentiality very seriously. While organizational information for seed and exploratory grants will not be shared with funders, organizations seeking implementation grants will be asked to disclose their information to funders so that they may understand the impacts of any planned transactions.
For exploratory and implementation requests, information about ALL collaborating organizations is needed when completing this form.
After you press 'Submit', you will be asked to review your completed inquiry. We will not receive a notification for your submission until you click 'Confirm'. While we can view drafts as they are populated, we will not be notified of your inquiry until you have confirmed your finalized submission.
The file size of all attachments cannot collectively exceed 35MB.

Contact Information of Submitter

Last Name

First Name

Email

Phone Number

Use format ###-###-####

Title

Organization

EIN

Website

Nature of Inquiry

If you have not yet had a conversation with SeaChange, we are happy to discuss your situation and our funding process prior to your completing the full grant application. If you'd like to do so, please email delaware@seachangecap.org.

Please elaborate on why you may be interested in exploring a strategic partnership and how you think the Fund for Delaware Collaboration might be able to help.

How did you learn about the Fund for Delaware Collaboration?

Please explain:

Project Stage

How many organizations are involved in this project?

Organization Information

Organization Information (Seed Grant)

Primary Contact Information

Last Name

First Name

Email

Title

Phone Number

Is the primary contact also the Executive Director / CEO?

Executive Director

Last Name

First Name

Phone

Email

Title

Organization

Street Address

Town/City

State

Zipcode

EIN

Please briefly describe the organization's mission and core programs/services.

How do you plan to use the seed grant?

What is the timeline for completing the work associated with the seed grant?

Please attach the scope of work/services for the seed grant.

Organization Information

Organization Information (Organization One)

Primary Contact Information

Last Name

First Name

Email

Title

Phone Number

Is the primary contact also the Executive Director / CEO?

Executive Director

Last Name

First Name

Phone

Email

Title

Organization

Street Address

Town/City

State

Zipcode

EIN

Please briefly describe the organization's mission and core programs/services.

Financial Information (Organization One)

If 'Other', please explain:

If 'Fiscally-sponsored entity', please explain the relationship:

How would you describe the organization's financial health?

In the most recent fiscal year, did the organization show a surplus, a deficit, or breakeven?

In the current fiscal year, do you expect a surplus, a deficit, or breakeven?

Documentation

Please upload as much of the documentation requested below as possible for our due diligence process.

Note: While these materials are not mandatory at this point, they will be required to move to the next phase of the process.

File Upload

IRS Tax-Exempt Certification

Latest Financial Audit (If a financial audit is not available, please provide end-of-fiscal-year P&L Statements for the previous two years)

Current Year Budget/Projections

Do you have additional documentation that you would like us to review?

Please upload up to three additional documents, if desired:

Other Document (#1)

Upload File

Please describe Other Document (#1):

Other Document (#2)

Upload File

Please describe Other Document (#2):

Other Document (#3)

Please describe Other Document (#3):

Contact and Organization Information (Organization Two)

Primary Contact Information

Last Name

First Name

Email

Title

Phone Number

Use format ###-###-####

Is the primary contact also the Executive Director/CEO?

Executive Director

Last Name

First Name

Phone

Email

Title

Organization Information

Organization

Website

Street Address

Town/City

State

Zipcode

EIN

Use format ##-#######

Please briefly describe the organization's mission and core programs/services.

Financial Information (Organization Two)

If 'Other', please explain:

If 'Fiscally-sponsored entity', please explain the relationship:

How would you describe the organization's financial health?

In the most recent fiscal year, did the organization show a surplus, a deficit, or breakeven?

In the current fiscal year, do you expect a surplus, a deficit, or breakeven?

Documentation

Please upload as much of the documentation requested below as possible for our due diligence process.

Note: While these materials are not mandatory at this point, they will be required to move to the next phase of the process.

File Upload

IRS Tax-Exempt Certification

Latest Financial Audit (If a financial audit is not available, please provide end-of-fiscal-year P&L Statements for the previous two years)

Current Year Budget/Projections

Do you have additional documentation that you would like us to review?

Please upload up to three additional documents, if desired:

Other Document (#1)

Upload File

Please describe Other Document (#1):

Other Document (#2)

Upload File

Please describe Other Document (#2):

Other Document (#3)

Upload File

Please describe Other Document (#3):

Contact and Organization Information (Organization Three)

Primary Contact Information

Last Name

First Name

Email

Title

Phone Number

Use format ###-###-####

Is the primary contact also the Executive Director/CEO?

Executive Director

Last Name

First Name

Phone

Email

Title

Organization Information

Organization

Website

Street Address

Town/City

State

Zipcode

EIN

Use format ##-#######

Please briefly describe the organization's mission and core programs/services.

Financial Information (Organization Three)

If 'Other', please explain:

If 'Fiscally-sponsored entity', please explain the relationship:

How would you describe the organization's financial health?

In the most recent fiscal year, did the organization show a surplus, a deficit, or breakeven?

In the current fiscal year, do you expect a surplus, a deficit, or breakeven?

Documentation

Please upload as much of the documentation requested below as possible for our due diligence process.

Note: While these materials are not mandatory at this point, they will be required to move to the next phase of the process.

File Upload

IRS Tax-Exempt Certification

Latest Financial Audit (If a financial audit is not available, please provide end-of-fiscal-year P&L Statements for the previous two years)

Current Year Budget/Projections

Do you have additional documentation that you would like us to review?

Please upload up to three additional documents, if desired:

Other Document (#1)

Upload File

Please describe Other Document (#1):

Other Document (#2)

Upload File

Please describe Other Document (#2):

Other Document (#3)

Upload File

Please describe Other Document (#3):

Contact and Organization Information (Organization Four)

Primary Contact Information

Last Name

First Name

Email

Title

Phone Number

Use format ###-###-####

Is the primary contact also the Executive Director/CEO?

Executive Director

Last Name

First Name

Phone

Email

Title

Organization Information

Organization

Website

Street Address

Town/City

State

Zipcode

EIN

Use format ##-#######

Please briefly describe the organization's mission and core programs/services.

Financial Information (Organization Four)

If 'Other', please explain:

If 'Fiscally-sponsored entity', please explain the relationship:

How would you describe the organization's financial health?

In the most recent fiscal year, did the organization show a surplus, a deficit, or breakeven?

In the current fiscal year, do you expect a surplus, a deficit, or breakeven?

Documentation

Please upload as much of the documentation requested below as possible for our due diligence process.

Note: While these materials are not mandatory at this point, they will be required to move to the next phase of the process.

File Upload

IRS Tax-Exempt Certification

Latest Financial Audit (If a financial audit is not available, please provide end-of-fiscal-year P&L Statements for the previous two years)

Current Year Budget/Projections

Do you have additional documentation that you would like us to review?

Please upload up to three additional documents, if desired:

Other Document (#1)

Upload File

Please describe Other Document (#1):

Other Document (#2)

Upload File

Please describe Other Document (#2):

Other Document (#3)

Upload File

Please describe Other Document (#3):

Merger and Sustainable Collaboration Application: Process Status

What is the status of the collaboration?

How urgent are these collaboration discussions?

Please very briefly explain the potential collaboration and the current status of the process.

What best describes the type of collaboration you are proposing?

How long ago did discussions begin?

Who first initiated discussions?

Is this the first time the organizations have been in discussions?

If a Memorandum of Understanding (MOU), Term Sheet, or similar document has been signed by the organizations, please attach it:

What are the principal benefits of the proposed collaboration?

What are the principal risks associated with the proposed collaboration?

How are the federal funding and policy changes impacting your organizations?

Merger and Sustainable Collaboration Application: Process (continued)

Have you estimated the one-time costs associated with exploring or completing the collaboration?

Please attach a spreadsheet with a breakdown of the estimated costs and note any which have already been paid.

Has a consultant/mediator/facilitator been engaged in the process?

Please explain who is retained (or who you expect to retain) and the process by which they were selected.

If you have signed (or expect to sign) an engagement letter, please attach it.

If you have any additional scopes of work or engagement letters for third party costs related the collaboration, please attach them.

Thanks for your interest

We strive to be respectful of the scarce time of our potential nonprofit partners. How long did this form take you to complete?

Do you have any comments on what would make it more helpful?

Note: If you experience an error submitting the application, it may be due to to all of the attachments uploaded exceeding a collective maximum of 30MB. If you receive a '413 Error', please go 'Back' in your browser, remove attachments, and email them to delaware@seachangecap.org.