The Ralph and Josephine Smith Fund for Northumberland County Grant Application Grants and scholarships from The Ralph & Josephine Smith Fund are made possible by the generous gifts of Josephine Smith, a woman with true vision for the future of her community. Mrs. Smith understood how endowed funding would provide new opportunities and solutions in her community well beyond her lifetime, and she gave the ultimate gift by creating a permanent fund at the Community Foundation. Every year, with income from the invested principle of Mrs. Smith's gift, this fund provides new charitable dollars in support of the programs of designated organizations that serve Northumberland County: the Warrior Run Library, Evangelical Hospital, SUN Home Health Services, and the Turbotville Community Hall Corporation. Additionally, the fund awards scholarships to students from the Warrior Run School District. In 2008, the Fund will also provide grants to other organizations that serve the residents of the Warrior Run School District through a competitive grant process. This application process will be guided by the Fund's local Advisory Committee, which will review all grant requests. Grant requests should take into consideration the amount The Ralph & Josephine Smith Fund has available to award. The Fund will have $17,000 available to grant in 2008. General Criteria for Reviewing Requests: The grant review process is competitive-there are always more funding requests than there is available funding. The Community Foundation favors proposals that: * Offer a creative response to the community's most pressing needs and concerns * Are preventative and farsighted rather than remedial * Maximize the impact of relatively modest grants * May involve cooperation or collaboration among program providers Limitations: Generally no grants will be provided for: * Clubs or sports teams Funding Request Process: * Applicants must be qualified to receive tax-exempt contributions as defined by the IRS-in the vast majority of cases, applicants will be 501(c)(3) organizations. * Applicants without 501(c)(3) status may work through another qualified 501(c)(3) organization that is willing to serve as a Fiscal Sponsor for the applicants (Fiscal Sponsor form attached). * Applicants must serve residents in the Warrior Run School District, if an applicant is located outside of the Warrior Run School District, but serves the residents of the Warrior Run School District, it is extremely important that you quantify how you serve the residents in the Warrior Run School District. * Applicants must submit 1 original and 6 copies of the application and all required attachments. Deadline and Response Process: * Applications must be postmarked no later than October 1, 2008 to be considered. No drop-offs or walk-ins will be accepted. * Notification will be made late September-early October. * The grant application can be found on our website at www.fcfpa.org. The Ralph and Josephine Smith Fund Grant Application General Instructions Guidelines for ( Submit 1 original and 6 complete, collated copies of all required materials Presentation ( Use 81/2 x 11" standard paper ( Number all pages ( Do not use typeface smaller than 11 points ( Include your organization's name on every page ( Provide materials in the order requested with the appropriate headings ( Use only clips for the application-do not staple, bind, or use notebooks or folders Application All applicants must include the following sections. We appreciate clarity and Materials and brevity in your responses. Instructions 1. Data Intake Sheet (attached) ( Please compete all sections ( This may be printed in blue or black ink or typed ( Feel free to scan and/or reproduce 2. Project/Program Description Using no more than 4 single-sided pages, describe your funding need. The following items must be addressed: 1. A description of the activity or service and how it relates to the organization's mission. For technology support, describe how the technology will improve program delivery for your organization. 2. The process and timeframe for developing the project/program or purchasing the equipment. 3. A list of the key staff, board members, consultants and service providers involved in the project. Briefly describe their roles. 4. Identify external support from the community. Include any in-kind support related to this application. 5. If applicable, identify target audiences and special populations to be served. 6. A description of how the project/program will be announced to the community. 7. Evidence that the program/project or technology purchase will be evaluated and measurable outcomes will be set. 3. Project Budget (attached) ( Please complete all sections. ( This may be printed in blue or black ink or typed. ( Feel free to scan and/or reproduce. 4. Support Materials ( Names of current board of directors and their occupations ( If filed, latest copy of the organization's IRS 990 form* ( 2 References - please include name, title, relationship to the organization, and contact information ( Detailed copy of the latest annual operating budget ( Resumes of key project personnel and contractors ( Other support materials, such as brochures, DVD's, etc. *Programs with budgets totaling less than $25,000 annually are legally exempt from this filing. The Ralph and Josephine Smith Fund Grant Application Data Intake Sheet Date: Agency: Name/Title of Administrator: Mailing Address: City/State/Zip Agency Phone: Fax: Email: Website: Contact Person Name/Title: Email: Phone: Program Name: Amount Requested: Program Description: (150 words or less. This section is required) The Ralph and Josephine Smith Fund Grant Application PROJECT BUDGET FORM Applicant: Project: Date: SECTION ONE - PROJECT INCOME Check One Funding Sources List each actual and/or anticipated source of funding for this project ONLY. Amount Funds Committed Funds Requested The Community Foundation Grant Box 1 Total Project Income Box 2 SECTION TWO - PROJECT EXPENSE Expense Items List expenses for this project. On a separate page, provide a brief description of any items that are not self-explanatory. Amount Amount of item to be funded by Foundation grant Total Project $ $ Should match Box 2 Should match Box 1 4 5