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DRAFT 2022 Agency Application for 2 Programs

  • 1. General Agency Information

  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Acceptable file types: jpg,jpeg,png,pdf,doc,xls
  • 2. Public/Private Grants and Capital Fundraisers

  • 3. 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: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Acceptable file types: jpg,jpeg,png,pdf,doc,xls
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    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 organization is not required to submit an audit. Acceptable file types: jpg,jpeg,png,pdf,doc,xls
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    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: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Upload your most recent fiscal year ended balance sheet comparative to prior fiscal year from your software program (not the auditor's report).
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Upload your most recent agency budget.
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Please provide a list of grants, donations and/or sponsorships over $5,000 received or to be received for the most recent FY .
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    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: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    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: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    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. For future fundraisers, list planned dates and projected profit.
  • 4. Program 1's Information

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

  • 6. Program Sustainability

  • 7. Individuals Served

    Provide number of unduplicated persons served by this program in each geographic area in the 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 most recent completed fiscal year or calendar year.
  • Gender

    To which gender identity did your client most identify? Actual statistics for your most recent completed fiscal year or calendar year.
  • Ethnicity

    Actual statistics for your most recent completed fiscal year or calendar year.
  • Income Level

    Actual statistics for your most recent completed fiscal year or calendar year.
  • 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 most recent completed fiscal year or calendar year.
  • 8. Outcome Measurements

    Use the form provided within the instructions for this application OR any form your agency uses to track outcomes.
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
  • 9. Program Financials

  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Please upload the program budget for the most recent fiscal year ended, if applicable.
  • 5. Program 2's Information

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

  • 7. Program Sustainability

  • 8. Individuals Served

    Provide number of unduplicated persons served by this program in each geographic area in the 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 most recent completed fiscal year or calendar year.
  • Gender

    To which gender identity did your client most identify? Actual statistics for your most recent completed fiscal year or calendar year.
  • Ethnicity

    Actual statistics for your most recent completed fiscal year or calendar year.
  • Income Level

    Actual statistics for your most recent completed fiscal year or calendar year.
  • 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 most recent completed fiscal year or calendar year.
  • 9. Outcome Measurements

    Use the form provided within the instructions for this application OR any form your agency uses to track outcomes.
  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
  • 10. Program Financials

  • Accepted file types: jpg, jpeg, png, pdf, doc, xls, Max. file size: 6 MB.
    Please upload the program budget for the most recent fiscal year ended, if applicable.
  • 11. Promotion

    To reduce the length of this application, we are NOT currently asking for a success story, photo or examples how a donation of a certain amount will impact our organization. Please note that we may ask for this information at a later date.
  • 12. 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.