Linda F. Zuker Memorial Youth Fund

Post Office Box 377

Chestnut Hill, MA 02467 
 

Funding Request

 

Date: _________________________________

 

1. Legal name of organization, address, and name of executive director:

 

 

 

2. IRS 501(c)(3) nonprofit? (Please circle)  YES   NO

2a. If yes, please provide a copy of the IRS letter confirming tax-exempt status.

2b. If no, identify your fiscal agent and attach the written agreement from the fiscal agent. (Funders using this form may have special requirements as to the use of a fiscal agent, or may not permit such use.)

 

 

3.  Contact person and title: _______________________________

 

4. Phone: _______________ FAX: ___________________  Email:__________________

 

5. AMOUNT REQUESTED: $__________________________

 

6. NAME OF PROJECT, PROGRAM OR ACTIVITY_________________

 

7. State your organization's mission:

 

 

 

 

 

 

8. No more than four sentences summarizing the proposal and its strategic link with the Linda F. Zuker Memorial Youth Fund

 

 

 

 

 

 

9.  List the proposal's target population, constituents, and geographic communities:

 

 

 

 

 

10. Total number of board members: ___ Total number of volunteers:___

11.  Total number of staff: Full-time _____ Part-time _____

12. Total annual organizational budget: $______________________

Fiscal Year End ___/___/___

13. Project or Program: $_____________

14. The period this grant will cover: ___/___ to ___/___

15. United Way affiliate? (Please circle):  YES   NO

16. List any previous support from this funder in the last five years.

17. How did you find out about our organization? ________________________

 

PROPOSAL NARRATIVE

 

No more than 3 pages. The following questions are ones that we have identified as important information to answer. While it is necessary to encompass all the following information in the proposal narrative, you may want to change the order in which you answer these questions.

 

 

  1. Brief summary of organization's history, goals, and key achievements.
  2. Describe the community or regional need(s) and/or challenges that this effort will address. What is the level and nature of involvement of the community-at-large?
  3. Description of the specific request that includes goals and objectives. (If it's a project request, provide a profile of the project)
  4. Specific activities and timetable for meeting your stated objectives.
  5. Future plan for sustaining this effort and strategy for building your funding base.
  6. Who are your staff and volunteers and what are their qualifications?
  7. If applicable, identify organizations that you collaborate with to address the issue(s) in this proposal.
  8. Define your criteria for success for the project, or program. State how you will measure your success in the short-term and in the long-term. What tool(s) will be used to evaluate your program or organization? What is your strategy for implementing the evaluation process?
  9. List companies and foundations being approached to fund this proposal, with dollar amounts indicating which sources are committed, pending, or anticipated.