Small Grants Program Application

Proposals are due by Friday, September 27th.

Please make sure that you read the eligibility guidelines and the NEW grant guidelines before filling out this application. You can save your work and an email will be sent to you with an edit link.

Grant Overview: https://www.tndisability.org/small-grants-overview

Grant Process: https://www.tndisability.org/application-process

If you have any questions or concerns or would like to request application accommodations please email smallgrants@tndisability.org.

Organization Information:

The organization working on this grant project:

Organization Name:*

Project Name, if different:

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:*

Please enter a valid phone number.

Federal ID Number:*

EIN, FEIN

Unrestricted Annual Budget: *

Grant Contact Information:

The Individual overseeing the work outlined in this application who is the main contact for receiving emails.

Full Name: *

First NameLast Name

Email:*

example@example.com

Phone Number*

Please enter a valid phone number.

Title:*

If the "Grant Contact" is submitting this application, please skip to the "Additional Organization Contact" section below.

Your Full Name

First NameLast Name

Your Email Address:

example@example.com

Your Phone Number:

Please enter a valid phone number.

Your Title & Company/organization:

Additional Organization Contact:

This must be a director, president, CEO or a member of your organization's executive board.

If you do not provide this information, or duplicate contact information from above, your submission will not be reviewed.

Name:*

First NameLast Name

Email:*

example@example.com

Phone Number:*

Please enter a valid phone number.

Title:*

Is the organization listed above the fiduciary organization?*

YesNo

Fiduciary Organization:

This is the organization receiving the grant funds if awarded.

Organization Name:

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Federal ID Number for :

Please, describe your organization:

History
Mission
Services
Community served
Why does your organization want to take on this project?

Organization Description:

Website, Social media, etc:

Project Details:

Please answer each question!

Provide a detailed project overview to include:

A Description of the project
The overall goal of the project includes short and long-term goals
The need being addressed by this project
How will you implement this project?
How will the community know about this project?

Description and goal of the project:

In keeping with the mission of the Coalition to help build a society that includes and values people with disabilities, the purpose of the small grants program is to build capacity in the disability community to serve individuals with disabilities and their families.

How will this project build capacity within the disability community?
How will it be sustained long-term after the grant ends?

If you need to revisit the definition of capacity building, please go to: https://www.tndisability.org/small-grants-overview

Capacity Building & Sustainability:

Describe the community that will benefit from this project including:

Describe your community.
Describe the disability community that you plan to reach.
How many people & families will benefit from this project?

Community & reach:

If your organization has received TDC grant funds before, please describe how this project is different.

Please provide the year[s] and project name[s] if applicable.

If your organization has not received TDC grant funds in the past you can skip this question.

Previously funded project[s]:

Impact & Outcomes:

Provide a detailed explanation of the anticipated impact, outcomes, and your evaluation process.

What impact do you anticipate for this project?
What do you hope the outcome will be?
How will you measure and evaluate the project?
- Surveys, testing, numbers, programs, etc...

Impact & outcomes:

Measure & evaluate:

Project Budget:

Please use the budget summary section to fully describe how these funds will be used.

Budget Summary:*

The amount you are requesting from the small grants program for this project. *

$15,000.00

Please use the link below to download the budget template and upload it in the "Budget" field below. with your application.

https://docs.google.com/spreadsheets/d/1D0bzrl6ri9VCxrFpcRItzGkvG-RNefdPGWgaEWTV-cc/edit?usp=sharing

Budget: *

Tax ID Form[s]:*

Certification & Submission:

We certify that the information contained herein is correct and complete. We agree to keep accurate financial records for any funds that might be received and to use any grant money strictly for the purpose detailed herein. We will comply in the event the Tennessee Disability Coalition asks to schedule site visits before and after the grant has been made, and we agree to submit the interim and final requested narrative and fiscal reports by the deadlines set forth by the Coalition. We will allow the Coalition to use the information provided in this request for public information pieces and will acknowledge the Coalition’s support in any publicity generated regarding this project:

To ensure that this form is as accessible as possible, please use the option that best fits you below be either signing or typing your name:

Organization Contact:

First NameLast Name

Signature Box

Organization Executive Contact:

First NameLast Name

Signature Box

Fiduciary Contact, if different:

First NameLast Name

Signature