Community Enhancement Grant Application 2023 Funding Period

Community Enhancement Grant Application

2024 Funding Period
Vision Statement

Roane County United Way (RCUW) will be the organization the community turns to when seeking lasting community change. We will be recognized as a catalyst for making a significant and measurable difference in our community. We will mobilize and enable partner agencies to achieve our mission and will be nationally recognized as a leading rural United Way in the area of community outreach.

Mission Statement

RCUW mobilizes the caring power of our community:
- To create long-lasting change that improves people’s lives, and
- To provide for the basic human needs of those needing assistance.
If you have questions about this application or the Community Enhancement Grant process, please contact Sandy Leavell, sleavell@unitedwayroane.org or call 865-882-7711, M-F 8:30-4:30.
Section 1 - Contact Information
Please note, any item marked with * is a required field and must be completed for submission.
Organization Name*
(Must match IRS form 990)
Organization Physical Address*

Street Address

CityState / Province

Postal / Zip Code
Mailing Address, if different than physical address. This is the address that the grant award will be mailed to.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
Website
IRS tax ID number (EIN)*
Contact Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
Does your organization use another organization for fiscal management or administration? If yes, please provide the contact information below.*

YesNo
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com

Section 2 - Program/Service Title, Grant Amount Requested Certification
Program Title(s):*
Total Grant Amount Requesting*
Maximum request for CE Grants is $5,000.00
How much of your budget will RCUW be providing?*
What % of the funds requested are part of your total operating budget?*
When are the funds needed? *
Please note that applications received will be reviewed and any awards allocated will be given by the end of the next Fiscal quarter. (I.e., applications submitted in first Quarter will be awarded by the end of the second Quarter.)
What will be the impact if your funding request is not fully funded?
What and when are the purchases/distributions to be made?*
Did you receive funding from the RCUW Community Enhancement Grant in the past, if so how much and for what program?*
PLEASE NOTE: IF YOUR ORGANIZATION HAS RECEIVED FUNDING THROUGH COMMUNITY ENHANCEMENT GRANTS FOR THE SAME PROGRAM OR SERVICE AREA FOR 3 OR MORE YEARS, APPLICATION FOR ADDITIONAL FUNDING MUST BE THROUGH THE COMMUNITY INVESTMENT GRANT PROCESS.

Section 3 - Description/Funds Request Details
Organization's Description (History, Mission and Past Accomplishments)*
Targeted Focus Area*
Service Gap Provided*
Describe intended use of grant funds, including specific outcome(s) projected, rationale for specific amount requested, how the request meets a community need in a service gap and/or focus area, and how the grant request represents a one-time request to start a new service or enhance an existing service as described in the Community Enhancement Grant Application Criteria.*
Are there other participating organizations?*

YesNo
Provide the funding amounts provided for this project by other organizations, if applicable.
Additional Information: Please list any additional comments related to your application that you feel are important for the Community Enhancement Committee in the area below:

Section 4 - File uploads and Counterterrorism Agreement
Please upload IRS 501(c)3 Determination Letter *

Cancelof
Please upload registration or exemption letter from the State of Tennessee; Division of Charitable Solicitations.*

Cancelof
Counterterrorism Agreement

1. In compliance with the USA PATRIOT ACT and other counterterrorism laws, we certify that all RCUW funds will be used in compliance with all applicable anti-terrorist financing and asset control laws, statutes, and executive orders.

2. We certify that an active and responsible governing body directs the organization named in this application whose members have no material conflict of interest and who all serve without compensation; that publicity and promotional activities are based on actual programs and operations; and that the organization is chartered or incorporated under the State of TN. We certify that the information provided for this application is true and accurate and either has been or will be shared with the entire Board.
Do you agree to the counterterrorism agreement?*

YesNo
Executive Director / CEO / President*

First NameLast Name
Phone Number
Please enter a valid phone number.
Signature*

Clear
Board Chair *

First NameLast Name
Phone Number
Please enter a valid phone number.
Signature*

Clear
Should be Empty: