Community Impact Grant 2026-2027

Mitchell Area United Way Community Impact Grant 2026-2027

Due: April 1st, 2026 5 p.m.
Agency Name:
Agency Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Above address same as physical mailing address?

Yes, we use the same addressNo, we use a different address
Agency Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Name

First NameLast Name
Contact Position
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email
example@example.com
Agency Website:
Agency Established Date:

MonthDayYear
Date
Agency Mission
Agency Program/Services (Please include percentages of total make up of operations)
Agency Statistics/Data (Nonduplicated Numbers by Program for 2024)
Agency Service Area (Please list counties/communities also served)
Is your agency or organization in good financial standing with the state?

YesNo
How does your agencies fiscal year run?
How much of your total budget is United Way funding?
What other funding sources make up your total budget?
What pillar does your mission fall under? (Select all that apply)

Financial StabilityEducationHealth
What amount of funding are you applying for this year from Mitchell United Way?
What specifically will you be using these dollars for?
If you didn't get Mitchell United Way funding, where would you seek your funding for your budget?
Why do you feel that your organization makes a great partner agency for Mitchell United Way?
Please list 3 goals or outcomes that you hope to achieve with funding provided by Mitchell United Way for the 2026-2027 year? Please remember these as a follow up to end of year reporting.
PLEASE UPLOAD AS ONE DOCUMENT the following:
- Financials (Statement of Financial Position, Balance Sheet, etc)
- Board Approved Budget
- Most recent Board Minutes
- List of Board of Directors
- List of Events / Activities Planned for Year
File Upload

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Please sign below to signify that the above information is true and accurate to the best of your knowledge
Signature
Date signed

MonthDayYear
Date
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Mitchell Area United Way Community Impact Grant 2026-2027