Swift Memorial Health Care Foundation Application

Swift Memorial Health Care Foundation Application
Grant Application Procedure

Please read the following information before starting your application.
The Foundation accepts and processes applications for grants and scholarships twice a year. The deadlines are April 15 and October 15.

For specific inquiries regarding the grants program, contact Phylene Wiggins, Vice President of Community Investments, at (805) 988-0196, Ext. 130, or send email to pwiggins@vccf.org.

Each application must include:
- Completed official Swift Foundation Request for Assistance/Grant Application Form and Project Budget & Financial Information Summary
- List of Current Agency Board of Directors with their community or professional affiliations
- One copy of the agency’s current 501(c)(3) letter verifying non-profit status
- One copy of the agency’s most recent annual audit. For organizations with an annual operating budget under $500,000 and/or without audited financial statements, in-house income and expense statements and a balance sheet are acceptable only if verified and signed by two officers of the agency’s Board of Directors.
ESSENTIAL CRITERIA FOR FUNDING:
- Each applicant must be a 501(c) (3) not-for-profit community-based organization and may submit no more than one application per year.
- Non-profit agencies must have an active Board of Directors and each application must include information indicating financial viability and capacity to conduct the project to be funded.
- The organization must be located in Ventura County or the program must serve Ventura County residents in accordance with the purpose of Swift Memorial Health Care Foundation by providing health care services to Ventura County residents.
Funds may be granted for such things as existing program expenses, program expansion, project start-ups, personnel expenses and staff or volunteer training directly related to the program. Funds may also be granted for technical assistance, equipment and facility costs directly associated with the proposed project.

Funds will not be granted for organizational deficits, annual fund drives, general operating expenses, political activities, religious or sectarian activities, endowments, research or non-project related expenses.

Swift Memorial Health Care Foundation prefers not to fund recurrent salaried positions. Grant sizes typically range from $3,000 to $10,000 and are usually awarded for accomplishing a definite purpose within a specified time period – normally not more than one year.

Agency Information
Name of Agency *
Name of Executive Director *
Email *
example@example.com
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Physical Location (if different from mailing address)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Website *
Phone Number *

Area Code Phone Number
Fax Number

Area Code Phone Number
Employer ID Number *
Please attach your agency's proof of Non-Profit Status/Incorporation 501(c)(3)

Browse Files
Please attach a PDF Cancel of

Request for Assistance
Dollar Amount Requested from Swift Foundation? *
Describe the services to be provided with the funds for which your organization is applying and how the funds will be spent. Please be as clear and as specific as possible. *
Is this request for funds for capital equipment? *

Yes No
If Yes, please attach a written estimate or invoice describing the equipment along with its cost. *

Browse Files

Cancel of
If Yes, please detail the description, life expectancy and intended use/purpose of the item. *
What communities will benefit from the services and/or equipment resulting from this grant? *
In the event the Swift Memorial Health Care Foundation only funds a portion of your request, please describe the impact on your agency and/or the proposed program or service. *

Project Budget

Please list total project costs below and indicate which costs are being proposed for funding by the Swift Memorial Health Care Foundation.

Staffing - List by position, include salary and personnel costs. (Please note that Swift prefers not to fund recurrent salaried positions.) *

Position Title

Hours/ Salary/ Benefits

Total Cost

Amount of Swift Funding Requested

Position 1

Position 2

Position 3

Position 4

Position 5

Position 6

Position 7

Position 8

Position 9

Position 10

Equipment/Supplies (List and explain) *

Item

Unit/Item Cost

Total Cost

Amount Requested from Swift

Item 1

Item 2

Item 3

Item 4

Item 5

Other Costs (List and explain) *

Description

Total Cost

Amount Requested from Swift

Other Cost 1

Other Cost 2

Other Cost 3

Other Cost 4

Other Cost 5

Total Project Budget
Total Amount Requested from Swift

Other Funding for This Project (List amount and source fo funding, pending or expected to be received, from other sources).

Type (grant, contract, etc.)

Source

Status

Amount

Funding 1

Funding 2

Funding 3

Funding 4

Funding 5

Funding Sources and Organizational Budget

Please provide information regarding current funding sources and expense for the organization's current fiscal year.
Report for Fiscal Year *
ex: 2020

Organization Income: *

Service Fees, Charges, Tuition

Program Income

Organization Income: *

Grants

Contracts/Fee for Service

Government Sources

Organization Income: *

Individuals

Corporate/Business

Foundations

Other

Contributions

Total Organization Income

Organization Expenses *

Expenses

Program Services

Fundraising and Financial Development Costs

Administrative and General Office Costs

Total Organization Expenses
If expenses exceeded income for the year, how has the deficit been financed? *
Please attach your most recent annual audit. For organizations with an annual operating budget under $500,000 and/or without audited statements, in-house statements are acceptable, but only if verified and signed by two officers of its Board of Directors. *

Browse Files

Cancel of
Please list your Board of Directors *
How often are Board of Directors meetings held? *

Monthly Quarterly Semi-Annually We do not have a Board of Directors

Submit Application
Thank you for filling out this application. If ready, please click the submit button below. Otherwise, you may click the Save for Later button and return to this application at a later time.

Please note, the Swift Memorial Health CAre Foundation accepts grant applications twice a year. The deadlines are April 15 and October 15. No organization may receive more than one grant in any 12-month period.

If the funds are approved, your organization will be responsible for a brief evaluation assessing your accomplishment. This evaluation is due at either the end of the project or one year from the date of receipt of the funds, whichever comes first. The Foundation will not consider new grant requests unless the evaluation has been received.
Should be Empty:

Swift Memorial Health Care Foundation Application

Grant Application Procedure

Agency Information

Organization Background

Request for Assistance

Project Budget

Funding Sources and Organizational Budget

Submit Application