2024 Bedford/Lincoln Grant Application

2024 Funding Application

Your Local United Way serving Bedford and Lincoln Counties

Section 1: Agency Information
Your local United Way serving Bedford and Lincoln counties is excited to announce our funding opportunity for 2024-2025.

Proposals for this one-year grant will be accepted beginning on April 1, 2024 and ending on April 26 at 11:59 pm cst. Please complete a separate application for each program for which you are applying. Please note that completion of this form does not guarantee funding.

Eligibility Guidelines
- Agencies providing health and human service programs in Bedford and/or Lincoln counties
- Non-profit organizations with 501(c)(3) status or IRS equivalent to nonprofit status
- Must have two full years of operation before requesting United Way funding
- New or existing programs that align with one of the funding priorities - Education, Income, or Health
Please complete the information for the Agency.*
Agency Street Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Agency Mailing Address (if different)

Mailing Address

Mailing Address Line 2

CityState / Province

Postal / Zip Code
Contact Person for this proposal:*
Executive Director*
United Way utilizes Giving Matters profiles to review documents and information for nonprofit grant applicants. If you do not have an up-to-date Giving Matters profile, we encourage you to create one. For help updating or setting up a Giving Matters profile, click here. Alternatively, you can upload the following documents below:
- 501(c)(3) verification
- Annual Audit
- 990 Form
- State Charitable Sollicitation Letter
- List of Board of Directors members
If you have an updated Giving Matters profile, you do not need to upload these documents.
Is your agency's Giving Matters profile current at the time of submission of this proposal?*

YesNo
Please paste a link to your Giving Matters profile.*
Upload the following documents: 501(c)(3) verification, annual audit, 990 form, State Charitable Solicitation Letter, list of Board of Directors members.

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Please provide your Agency Mission Statement.
Please choose the appropriate funding category:

Education: preparing children and youth to become responsible adults who are emotionally, cognitively, and physically prepared to succeed in school, work, and their community; education and vocational skills to improve employability and create opportunities for self-sufficiency; promoting safety and disaster/crisis responseIncome: addressing basic, temporary, and urgent needs including food and shelter; enhancing financial stability, safety, and disaster/crisis responseHealth: maintaining and improving physical and mental health services and access to those services at all ages of the life cycle

Section 2: Program Information and Description
Please describe the program for which you are requesting funding by answering the following questions. If you are completing the application for your agency, please answer the questions with regard to your agency. If you are completing the application for a specific program, please answer the questions with regard to the program.
Title of this Proposal (Program or Service Name)*
Please provide a brief description of the program or services provided in Bedford and/or Lincoln Counties. *

0/50
Provide a detailed description of the program. What are the program activities? What is the plan for implementation or continuation? Include description of program capacity, intensity, and duration of services.*

0/250
What are the eligibility requirements (if any) for your services?

0/100
Are there procedures in place for measuring the results achieved by your agency/program? If so, describe the methods utilized.*

0/250
Has your agency used evaluations to improve its program? If so, explain the process and improvements.*

0/250
How many volunteers serve in your organization? Describe in what capacities they serve and your average volunteer hours for the year.*

0/100
Do you currently have, or have had in the past year, a waiting list for the services of your program? Please explain.*

0/100
What other agency in this county provides a similar service/program?*

0/100
If fees are charged for services supplied by your program, what provisions are made for clients who are unable to pay full fees?*

0/100
Please provide a success story of a client from this program or agency. Please note that this information may be used in public mediums and print materials, so please change any names or identifying information.*

0/250

Section 3: Budget & Demographic Information
Amount Requested
What percent of your local program budget is your allocation request?
Please provide the budget for the program or agency. You may download and utilize the Program Budget template to complete and upload or upload the agency budget you currently utilize.
Upload Program or Agency Budget *

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Based on the proposed budget, please explain specifically how the requested amount would be spent.*

0/250
If you receive less money than requested, what impact would this have on the program and the individuals served?*

0/100
How many individuals will this program serve?
Please download the Demographics Template, complete the spreadsheet with the projected demographics, and then upload the completed spreadsheet.
Upload Demographics Template*

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Final Agreements and Submission
Please review Diversity, Equity, and Inclusion statement of your local United Way serving Bedford and Lincoln Counties.
Does your agency acknowledge and align with the Diversity, Equity, and Inclusion statement?*

YesNo
Please download the Patriot Act Form and upload the completed form.
Upload Patriot Act*

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Please download the Partnership Agreement and upload the signed form.
Upload Partnership Agreement*

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Save and finish later?

The Save button below will open a new dialog box where you may choose to sign up or log in to a free Jotform account to save and easily manage the application drafts in your account. You can also use the Skip Create an Account link at the bottom of the save dialog box to get a link to the draft application or have it emailed to you.

When you are done with your application, please click the Submit button.
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2024 Funding Application