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Agency General Application – 2 Programs

  • 1. General Agency Information

  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
  • 2. Public or Private Grants

  • 3. Capital Fundraiser

    Capital Fundraisers are one-time campaigns set within a definite time frame for a special or specific major project (building, endowment, and/or major equipment usually over $25,000).
  • NOTE: AGENCIES INTENDING TO CONDUCT CAPITAL CAMPAIGNS ARE OBLIGATED TO COMPLY WITH UNITED WAY’S POLICY ON FUNDRAISING ACTIVITIES.
  • 4. Statement of Financial Position

    Upload documents for each item below using figures from most recent FY audit or your financial software program. If you don't have one of the required documents, you may skip the step, but the form requires that you upload a document so you may upload a blank Word document.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Upload your most recent Form 990, 990EZ or 990 postcard.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Including auditor's opinion letter and management letter. If your agency budget is less than $100,000, an audit is not required. Just upload a document that explains your origination is not required to submit an audit.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Upload your most recent fiscal year ended profit & loss report comparative to prior year from your software program (not the auditor's report).
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Upload your most recent fiscal year ended balance sheet comparative to prior year from your software program (not the auditor's report).
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Upload your most recent agency budget.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Please provide a list of grants, donations and/or sponsorships over $1,000 received or to be received for the fiscal year that includes December 2020.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Please provide a list of donor restricted funds including the amount, reason for restriction, and if any investment earnings are available for unrestricted expenses.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    If your agency has an endowment fund please includ the amount, reason for the fund, and if any investment earnings are available for unrestricted expenses.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Please attach the same list for any fundraisers planned within the next year.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Please attach a list of all fundraisers (including direct solicitations) your organization had in the past 12 months. List dates of each, location and net profit.
  • INFORMATION ABOUT PROGRAM 1

    Please prepare one Program Information Section for each United Way of Whiteside County funded program.
  • 1. Funding Requests For This Program

  • 2. Program Background

  • 3. Coordination and Collaboration

  • 4. Program Sustainability

  • 5. Individuals Served

    Provide number of unduplicated persons served by this program in each geographic area in the last fiscal year. (Auxiliary or supportive services, such as survey, brochure, and newsletter are not to be counted as persons served.) Numbers listed below should be UNDUPLICATED numbers.
  • Age

    Actual statistics for your funding (calendar) year 2020
  • Gender

    To which gender identity did your client most identify? Actual statistics for your funding (calendar) year 2020
  • Ethnicity

    Actual statistics for your funding (calendar) year 2020
  • Income Level

    If available as defined by your agency. Actual statistics for your funding (calendar) year 2020
  • How does your agency define low income?
  • How does your agency define moderate income?
  • How does your agency define high income?
  • Numbers of people served by location

    Actual statistics for your funding (calendar) year 2020
  • 6. Outcome Measurements- Must use template

    Use the form provided within the instructions for this application.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
  • 7. United Way Community Pillars

    Please indicate where your United Way allocation dollars will be spent. The dollar amount in all the categories should equal the amount of total dollars requested. The undefined category is for those programs that do not serve persons in the other categories.
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • 8. Program Financials

  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    Please upload the program budget for the most recent fiscal year ended, if applicable.
  • INFORMATION ABOUT PROGRAM 2

    Please prepare one Program Information Section for each United Way of Whiteside County funded program.
  • 2. Program Background

  • 3. Coordination and Collaboration

  • 4. Program Sustainability

  • 5. Individuals Served

    Provide number of unduplicated persons served by this program in each geographic area in the last fiscal year. (Auxiliary or supportive services, such as survey, brochure, and newsletter are not to be counted as persons served.) Numbers listed below should be UNDUPLICATED numbers.
  • AGE

    Actual statistics for your funding (calendar) year 2020.
  • Gender

    To which gender identity did your client most identify? Actual statistics for your funding (calendar) year 2020
  • Ethnicity

    Actual statistics for your funding (calendar) year 2020
  • Income Level

    If available as defined by your agency. Actual statistics for your funding (calendar) year 2020.
  • How does your agency define low income?
  • How does your agency define moderate income?
  • How does your agency define high income?
  • Numbers of people served by location

    Actual statistics for your funding (calendar) year 2020
  • 6. Outcome Measurements - Must use template.

    Use the form provided within the instructions for this application.
  • Accepted file types: basedonyourrequestforprogramfunding, howmuchwillbespentonthisunitedwayfocusarea?.
  • 7. United Way Community Pillars

    Please indicate where your United Way allocation dollars will be spent. The dollar amount in all the categories should equal the amount of total dollars requested. The undefined category is for those programs that so not serve persons in the other categories.
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Based on your request for program funding, how much will be spent on this United Way focus area?
  • Program Financials

  • Accepted file types: basedonyourrequestforprogramfunding, howmuchwillbespentonthisunitedwayfocusarea?.
    Please upload the program budget for the most recent fiscal year ended, if applicable.
  • How has COVID-19 affected your organization? How do you think it will affect your organization in 2021?
  • 9. Promotion

  • Provide a success story from this program that can be shared publicly. If needed, you may change names to protect the identity of children and those in sensitive situations.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    If possible, provide a photo that can be used publicly, including social media. If the picture includes identifiable people a photo release is also required. A photo will result in additional promotion of your program and will be beneficial to both United Way and your organization.
  • Accepted file types: acceptablefiletypes:jpg, jpeg, png, pdf, doc, xls, xlsx.
    If the picture above includes identifiable people, a photo release is also required. Feel free to use your own photo release form.
  • Use specific examples for each of the dollar amounts below explaining how a donation of that amount will impact the community. Example: Your gift of $5 per week helps children recover from the effects of child abuse with four counseling sessions. Fill in the dollar amounts below with specific examples of how a donation of that amount will impact the community. $1 per week ($52) $5 per week ($260) $10 per week ($520) $25 per week ($1300)
  • 10. Signature

    In the event any of the information contained in this allocation request is deemed false or misleading, United Way of Whiteside County reserves the right to place restrictions on the Agency’s use of United Way money or to reduce or terminate funding.