2025-26 Allocations Application for Funding - United Way of the Upper Ohio Valley

  • 2025-26 Allocations Application for Funding - United Way of the Upper Ohio Valley

    Agency Information
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
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  • 0/500
  • 12. Does the Agency utilize and actively keep updated and current the following (Select all that apply)*

  • Funding Requests

    United Way funds programs that comprehensively focus on solving the priority needs identified by the United Way Community Impact Initiative as identified by United Way Worldwide. These are (and can include but are not limited to): Healthy Communities, Youth Opportunity, Financial Security, and Community Resiliency. Granted funds can only be applied for the use of programs/projects that provide a direct service to an individual or family. Grants will not be considered for capital improvements.
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  • Programs

  • Is this program:*
  • 20. Area(s) of Impact this program fits under*
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  • 23. Populations Served - Please indicate specific populations that your agency is serving/focusing on in your program. Select ALL that apply*
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  • 25. Counties this program serves*
  • 26. Months program services are available*
  • 27. Days program services are available*
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    • Program 2 
    • Is this program:*
    • 20.1 Area(s) of Impact this program fits under*
    • 0/500
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    • 23.1 Populations Served - Please indicate specific populations that your agency is serving/focusing on in your program. Select ALL that apply*
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    • 25.1 Counties this program serves*
    • 26.1 Months program services are available*
    • 27.1 Days program services are available*
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    • Program 3 
    • Is this program:*
    • 20.2 Area(s) of Impact this program fits under*
    • 0/500
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    • 23.2 Populations Served - Please indicate specific populations that your agency is serving/focusing on in your program. Select ALL that apply*
    • 0/500
    • 25.2 Counties this program serves*
    • 26.2 Months program services are available*
    • 27.2 Days program services are available*
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    • Program 4 
    • Is this program:*
    • 20.3 Area(s) of Impact this program fits under*
    • 0/500
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    • 23.3 Populations Served - Please indicate specific populations that your agency is serving/focusing on in your program. Select ALL that apply*
    • 0/500
    • 25.3 Counties this program serves*
    • 26.3 Months program services are available*
    • 27.3 Days program services are available*
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  • Program(s) Details

  • 41. Are you expecting funding from any earned revenue?*
  • 0/500
  • 0/500
  • 0/0
  • 44. Do you have a sliding fee scale?*
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  • 45. Does your agency charge fees?*
  • If yes, are services at no cost to those under the Federal Poverty line?
  • 0/500
  • 46. Does your agency make revenue from sale of goods?*

  • Impact Statistics

    Impact Report of Service Statistics for the fiscal year July 2023-June 2024. Numbers must be based on what the United Way of the Upper Ohio Valley funded: specific services of your agency. Instructions: Each individual is to be counted one time only for the year. (Even if they receive multiple services). Note: number of families equals family units served. (Not number of adults served plus number of children served).
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  • Volunteer Information

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  • Funding Sources

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  • What is your agency’s administrative overhead cost percentage? 

    Note: This cost MUST BE LESS THAN 28%. Otherwise, you must include an explanation below and the plan to reduce these costs to less than 28% at the time of application. This explanation must be more than just a plan to raise more funds. If the agency does not file a regular IRS Form 990, the agency must still complete at the minimum page 1 and sign it, and pages 9 and page 10, all from the regular IRS Form 990. This is for United Way purposes only. The correct 990 is found on the IRS website at www.irs.gov and it is easy to complete.  If the IRS does not require your agency to file the Form 990 or requires you to file another form, you must still complete the regular IRS 990. IRS Forms 990 EZ, 990PF, and comparable forms are not acceptable. These IRS 990 forms are for application purposes only and will not be filed with the IRS. Please attach a copy of the most immediate year to this application, even if you have already submitted it to our office at another time.
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  • Agency Certification Letter

  • I certify that as a representative of   *   duly noted the above Funding Request is presented to the United Way of the Upper Ohio Valley for confidential use in its Funding process.
    I agree and understand that any falsification of information herein, regardless of the time of discovery, may cause forfeiture on our part of any funding by United Way of the Upper Ohio Valley.
    I certify that, to the best of my knowledge, the agency has the financial capacity to deliver the programs for the period of time covered by this application.
    In addition, I certify that to the best of my knowledge, we are in compliance with any legislation, ordinance, codes, taxation laws, rules and regulation applicable to not-for-profit organizations.

    Name of person completing this section:    *   *       
    Title:      *   
    Date:   Pick a Date*   

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