The Shaddock Foundation Grant Proposal Form

Cover Summary

Date: _________________________________

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

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

2a. If no, identify your fiscal agent and attach the written agreement from the fiscal agent.

3.Contact person and title: _______________________________________________________

4. Phone: ___________________ FAX: ___________________ Email: ___________________

5. AMOUNT REQUESTED: $__________________________

6. TYPE OF REQUEST (operating, project, capital, other): _________________________________

7. State your organization's mission:

8. Please summarize the proposal (Include the name of the project or capital campaign, if applicable):

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 capital budget (if applicable): $______________________________________________

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

Proposal Narrative

Up to 10 pages is suggested. 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.

Profile of your organization and of your request

If you are requesting operating support, please provide information about your organization's overall programs

and activities.

If you are requesting project or capital support, please provide information for that specific project or capital

request.

1. Brief summary of organization's history, goals, and key achievements.

2. Overview of organization's structure and programs, including board, staff, and volunteer involvement.

3. Describe your organization's constituents for the organization overall, or, for a specific project. For example, total

number and breakdown by age, gender, race/ethnicity, income levels, disabilities, geography, language spoken, or

other criteria relevant to your organization or project. (give general outline)

4. 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?

5. Description of the specific request that includes goals and objectives. (If it's a project request, provide a profile of the

project)

6. Specific activities and timetable for meeting your stated objectives.

7. Future plan for sustaining this effort and strategy for building your funding base.

8. Who are your staff and volunteers and what are their qualifications?

9. If applicable, identify organizations that you collaborate with to address the issue(s) in this proposal.

Evaluation

10. Define your criteria for success for the organization, project, or capital campaign. State how you will measure your

success in the short-term and in the long-term.

11. Attachments

All of the following attachments must accompany the proposal

1. IRS letter confirming tax-exempt status - 501(c)(3) and 509(a).

2. Current board list with relevant background, affiliations, town residence, and number of times a year it meets

3. Financial information:

Total board approved organizational budget for the fiscal year(s) (see page 4 for details)

If seeking project or capital support, include project or capital budget for fiscal year(s)

Most recent independent audit or account review (as required by law)*

Year-to-date financial statement for the current fiscal year

List companies and foundations being approached to fund this proposal, with dollar amounts indicating which sources

are committed, pending, or anticipated

Proposal Budget/Budget Narrative

2 PAGES MAXIMUM

1. Time period budget covers:

2. Revenue: provide a line item revenue statement for all applicable budget categories.

a. Grants and Contracts

Local Government

State Government

Federal Government

Foundations and Corporations

United Way and Other Federated Campaigns

b. Other Fundraising and Earned Income

Individuals

Events

c. Earned Income

Publications and Products

Membership Income

Fees

3. Expenses: provide a line item expense budget, with narrative footnotes for those applicable items that need further

explanation. Typical line items might include:

Salaries (specify number of full time equivalents)

Payroll Taxes

Fringe Benefits

Consultants and Professional Fees

Insurance

Travel/Transportation

Equipment

Supplies

Printing and Copying

Telephone and Fax

Postage and Delivery

Rent

Utilities

Maintenance

Evaluation

Staff Development and Training

Child Care

Administrative Overhead

4. In-Kind Support

Mail proposals to The Shaddock Foundation, 510 N Street, SW, Suite 32, Washington, DC  20024

Email Help@Shaddock.Org with any questions. (Foundation question only!)

Before You Begin! Important Note:

If you already prepare organizational, project, or capital budgets which include revenues and expenses, you may submit them in their original form, or use the following sample.

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