Request For Funding FY24 | United Way of Greater Fall River

Application for Funding FY24

This application is for United Way of Greater Fall River Funding for FY24 (July 1, 2023 to June 30, 2024). Please be sure to read the United Way Impact Grant Handbook prior to beginning this form. Make sure you have all required documents in hand before beginning the application. If you Save and Continue this form, the form will send a link to your email. United Way can not access your form until it has been officially submitted. Please be sure to check your Spam, Junk, or Promotions folder for the Save and Continue Link. The form WILL NOT save documents attached if you choose to "Save and Continue."

Step 1 of 7

Agency Information

Agency Name(Required)

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Is your mailing address different than your physical address?(Required)

Yes

Mailing Address

If different than physical address

Street Address Address Line 2 City State ZIP Code

Website(Required)

Social Media Handles(Required)

Do you have a fiscal agent?(Required)

Yes

Fiscal Agent Agency(Required)

Fiscal Agent EIN(Required)

Fiscal Agent Address(Required)

Street Address Address Line 2 City State ZIP Code

Fiscal Agent Contact Name(Required)

First Last

Fiscal Agent Contact Phone(Required)

Fiscal Agent Contact Email(Required)

Agency EIN Number(Required)

Chief Professional Officer Name(Required)

Prefix First Last

Chief Professional Officer Phone(Required)

Chief Professional Officer Email(Required)

Chief Volunteer Officer Name(Required)

Prefix First Last

Chief Volunteer Officer Phone(Required)

Chief Volunteer Officer Email(Required)

Board Demographic Data

Total Number of Board Members(Required)

What percent of your board gives to your agency?(Required)

What percent of your board is male?(Required)

What percent of your board is female?(Required)

What percent of your board is LGBTQIA+?(Required)

What percent of your board is white (not Hispanic or Latino)?(Required)

What percent of your board is Hispanic or Latino?(Required)

What percent of your board is Black or African American?(Required)

What percent of your board is Asian?(Required)

What percent of your board is American Indian or Alaska Native, Native Hawaiian or other Pacific Islander?(Required)

What percent of your board is "other"?(Required)

Staff Demographic Data

Total Number of Staff Members(Required)

What percent of your staff donates to your agency?(Required)

What percent of your staff is male?(Required)

What percent of your staff is female?(Required)

What percent of your staff is LGBTQIA+?(Required)

What percent of your staff is white (not Hispanic or Latino)?(Required)

What percent of your staff is Hispanic or Latino?(Required)

What percent of your staff is Black or African American?(Required)

What percent of your staff is Asian?(Required)

What percent of your staff is American Indian or Alaska Native, Native Hawaiian or other Pacific Islander?(Required)

What percent of your staff is "other"?(Required)

Date of prospective employee giving campaign for United Way of Greater Fall River

This is required for Allocation Grant Recipients

Measuring Impact in Greater Fall River

What is the desired outcome of this program?(Required)

How will you determine the success of this program? Please provide specific outcomes.(Required)

Please break out short, mid, and long term goals. For example: 5 job seekers maintain employment for 6+ months after support; behavioral referrals by teachers are reduced by 30% after social emotional learning lessons with behavioral health staff; etc. We recognize that some programs have broad impact on a lot of individuals while some programs serve smaller numbers more deeply. Use this space to show how YOU measure impact in your specific program.

What evaluation process will you use to assess the results of this program/service?(Required)

How will you collect data throughout this program?(Required)

Do you collect disaggreate data?(Required)

Yes

Do you partner with other agencies for this data collection/analysis?(Required)

Yes

With whom do you partner for data collection/analysis?(Required)

Describe the steps you have in place to revise or revisit the program if sucess is not being met during this grant cycle.(Required)

Resources Needed

Funding amount requested(Required)

No funding requests over $10,000 will be considered

Please enter a number from 0 to 10000.

Has United Way funded this program in the past?(Required)

Yes

Not Sure

How many years has United Way provided funding for this program?(Required)

What is the average amount of funding provided by United Way for this program?(Required)

Are there other funding sources for this program?(Required)

Yes

Additional Funding Sources(Required)

Please identify all additional funding sources and the relationship between these funds and those being requested. Please note specific criteria if additional funding requires a match.

Will you be collaborating with any other public or private organizations for this program?(Required)

Yes

Maybe

What other organizations will you be working with for this project/service? What specific or unique resources will others provide?(Required)

What is the timeline of events for this program?(Required)

Duration of time, number of meetings, etc. Please note that all programs must be run within FY23 (July 1, 2023 to June 30, 2024)

Agency Organization Chart(Required)