United Way of Hood County Community Impact Grant Application

United Way of Hood County Community Impact Grant Application

Application Due Date: Thursday, August 1, 2024
Organization Name*
EIN Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Website*
Facebook
Number of Paid Staff*
Number of Individual Volunteers *
Mission Statement*
CEO / Executive Director Contact Information
Name*
Title*
Email Address*
Phone*
Please select the United Way of Hood County Initiatives that best align with your programs.*

Empowering Academic Excellence: Fostering brighter futures by boosting academic achievement for all in Hood County.Fueling Financial Stability: Investing in financial sustainability to ensure everyone in Hood County can thrive today and build a stable tomorrow.Nurturing Holistic Well-being: Promoting healthy mental, physical, and emotional health, laying the foundation for a resilient Hood County.
Is your organization a current United Way of Hood County partner agency?*
What is the purpose of your organization?*
What are your organization's goals and objectives?*
What are the specific needs of Hood County that your organization is addressing?*
Funding Request Amount:*
Please list any fee for services you have for this project.
Describe the project you will fund with the Community Impact Grant and how it will address the community needs.*
What is the impact that you expect to have on your community as a result of this grant?*
How will you measure the success of your project?*
How will you ensure that the grant funds are used effectively and efficiently?*
Number of unduplicated individuals served by your agency in the last year.*
Estimated number of individuals not served due to limited resources. *
Is there anything else you would like us to know about your program?

Budget for Program to receive funds from UWHC*

Rows	FY 2023	FY 2024	FY 2025 request
Annual Budget
Annual Program Investment from UWHC
All other grants and program revenue

Please upload your Board approved agency budget.*

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Please upload your most recent 990.*

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Please upload a list of your current Board of Directors*

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File Upload

Optional: Adiditional Information
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Does the agency operate according to a written non-discrimination policy that complies with local, state, and federal nondiscrimination laws regarding hiring and employment practices and provisions of services?

YesNo
By signing this application, I attest that the information provided is accurate and truthful to the best of my knowledge.
Signature*
Name and Title of Signer*
Should be Empty:

United Way of Hood County Community Impact Grant Application

CEO / Executive Director Contact Information