Project Colleague Funding Request Form

Foothills Community Alliance

Community Project Funding Guidelines

PURPOSE: Foothills Community Alliance (FCA) is an association whose purpose is to enhance the community by providing the means by which the residents of Columbia Valley may create long-term self- reliance and health equity, and to implement permanent, meaningful projects that benefit the entire community. It focuses efforts around key issues with a mission to support children, young families, elderly, and individuals so they can develop the skills and opportunities they need to lead healthy, productive lives.

USE OF FUNDS: Funds are to be used on behalf of the residents of Columbia Valley, the geographic area which includes the Urban Growth Area of Columbia Valley. A map of the area can be made available upon request. The funds disbursed on behalf of the community (such as to a vendor/contractor, fiscal sponsor or non- profit organization) must benefit the community at large or address a specific issue of concern to the community. Funds cannot be dispersed for the benefit of any individual. Funds must be for an identifiable community benefit which can be documented as to its anticipated outcomes, including at a minimum, the number of people who will benefit.

REQUEST FOR FUNDS: Individuals or organizations requesting funds from the FCA Board will be asked to complete the Request for Funds Documents and submit a written proposal or presentation no later than the 25th of the Month prior to our scheduled monthly meetings to be added to the agenda. FCA General Monthly meetings are held the 2nd Wednesday of each month. Individuals are required to provide at a minimum 2-3 quotes when requesting funds for services or products. Individuals will be scheduled to attend an FCA Board meeting to formally present their request for funding to be considered. FCA approvals may be delayed up to 30 days if additional material or questions arise during the presentation. Written proposals and all other required documentation may be attached to the following application. Requests will be limited to one project per submittal. Allow 30 days after project approval for funds to be released. Applicants should allow 30-60 days before funding is released.

FUNDING PRIORITIES: Foothills Community Alliance (FCA), will represent the Columbia Valley community in determining the optimal use of funds. FCA will work to ensure diverse and equitable community representation and broad community engagement in determining how the funds provided for community projects can most effectively increase community health and wellbeing. When considering funding a project, FCA Board Members will focus on the following needs in our community. Access to healthy food sources, Access to medical, dental and pharmaceutical services, Provide safe, clean, drug-free neighborhoods, Provide parks, trails and recreational activities, Focusing on the most vulnerable populations in our community such as; youth, elderly, homeless, mentally ill, among so many others.
Project Funding Request - CHECKLIST

Use this list as a guide through the process. Items are not necessarily in order. Please contact the FCA Board with any questions.
Project Funding Request Form

Please note: Once complete, applicants must provide FCA a minimum of 6-8 days notice to be added to the next meeting agenda. FCA may take up to 30 days before a final decision is made to finance a project pending additional requested materials. Please allow 30-60 days before approved funding is released.
Name of Affiliate Organization(s):*
Applicants must have a current 501 non-profit status or be contractually partnered with an established fiscal sponsor (affiliate), where funds can be sent and managed if approved for funding. Your request will be reviewed prior to consideration. Please list your partners mentioned above in this box. If a fiscal sponsor is needed, please notify the FCA Board for suggestions.
Contact Person*
Title
Email*
Address*
City*
State*
Zip Code*
Primary Phone Number*
Include Area Code
Fax Number
Include area code
Website Address:
example@example.com
Project Contact Person Name (name of person requesting funds)

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Event/Program Information
Name of the event or program*
Please identify the name of the event or project here
Projected date of event or program*
Please Note: The FCA Board should be notified of the final event details to help increase awareness of the event at the FCA Project Lead level for recording purposes.
Number of community members expected to attend event:*
Targeted "Community Needs" Focus Area (check those that apply)*

Access to Healthy Food SourcesAccess to Medical, Dental, Pharmaceutical ServicesProvide Safe, Clean, Drug-Free NeighborhoodsParks and Recreation Activities or ServicesFocus on Families with ChildrenFocus on Elderly NeedsFocus on homeless, jobless, at risk populationsCommunity Wellbeing & EducationOther
Brief description of event or project:*
Method in which community members will be invited/recruited to attend event*
List Outreach Efforts: (i.e. U.S. Mail, Email, Facebook, E-vite programs, personal contact, phone calls, etc.)

What step(s) have you taken, independent of this application, to secure support for this endeavor?*

Secured SponsorshipFundraising, GrantsProgram leader identified and committedOther
Please describe your choices from above including any amount received already for project.*
Total estimated cost of event:*
Total amount requested from FCA:*
Please provide the projected expenses by line item and include any supporting documentation. The total amount of the line items must add up to the total dollar amount you are seeking. Please include ALL expected expenses, including administrative fees.*
Upload any supporting documentation here: Applicants shall provide a written project proposal and presentation material for review. Note that Individuals must provide at a minimum 2-3 quotes for services or supplies requested. This documentation shall accompany the request at the time of submittal.

Upload a File
Max 100 MB. All proposals and presentations will be reviewed carefully. Cancelof
Recipients of FCA Community Project Funds are asked to report the results of the recruitment activity or event to the Board on Membership/Volunteers by using the POST Project Report form. By signing this form, the applicant component or affiliate agrees to complete the reporting form and submit it back to the Foothills Community Alliance Board at: info@foothillscommunityalliance.com no more than 5 days after the event.

Recipients of FCA Community Project Funds agree to provide photo releases, newsletters, collateral materials, permission to share on the Foothills Community Alliance webpage.
Signature:*

Clear
Date:
Phone Number

Area CodePhone Number

Should be Empty:

Project Funding Request - CHECKLIST

Project Funding Request Form

Event/Program Information