United Way of South Central Indiana 

United Way of South Central Indiana 
431 South College Ave, Bloomington, IN  47403 
931 15th Street, Suite 107 Bedford, IN 47421 
 
Phone: 812-334-8370 
www.unitedwaysci.org 
   
 
Connecting people to possibility 
 
 
Please contact Randy Rogers at randy@unitedwaysci.org or  
Carmen Chamorro at carmen@unitedwaysci.org or call  
812-269-1018 for more information about this application.  

Form Instructions

You are encouraged to save your form as you go.

There is no need to create an account.

It will be easier for your board chair to sign the form if no account is created. Simply select "Skip Create an Account" on the SAVE screen. You will be prompted for your email address to receive your form link.

At the end of the form your Board Chair will need to digitally sign this document.

(A) If you created an account, you will need to share your login information with them so that they may access your in-progress form.

(B) If you have not created an account, you can forward them the email with the in-progress link and they should be able to access the form.

When the Board Chair accesses the form they should select "Continue with Draft", sign the form, and select "Save."

Then you may finalize, review, and submit the form.

Document Upload Reminder

For your convenience, please review the list of required documents in advance so you can have them ready to upload when completing the application.

You will be asked to submit:

• IRS Determination Letter (501(c)(3) status)
• Organization Bylaws
• Board of Directors List (names, titles, affiliations)
• Most Recent IRS Form 990
• Independent Audit or Financial Review

Save your updates to avoid losing progress

The following sections are designed to help you tell your story. The bullet points are optional prompts to guide your response, you do not need to answer every one. Share what best represents your work, impact, and potential. If you reference materials like evaluations, reports, or media, feel free to include them.

ORGANIZATIONAL IMPACT

Explain how your organization makes a positive difference in your community. Think about:  
- Explain how your mission and programs align with UWSCI’s impact areas. 
- The important changes or impacts your organization wants to make.  
- The main issues your work tackles and the results you're trying to achieve. 
- The backgrounds and experience of your team and how this helps your impact.  
- What you hope to achieve in the next three to five years, or a time frame you prefer. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

BENEFICIARIES

Describe your agency’s clients and the need for your services.   
- Provide demographic and descriptive data for those you serve. 
- Identify geographic, cultural, and population-specific details. 
- Describe anticipated cognitive, emotional, and behavioral changes. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

NEED JUSTIFICATION

Explain the specific community need and why it is urgent. 
- Use both quantitative (data, statistics, reports) and qualitative (stories, testimonials) evidence. 
- Show how this funding is essential to achieving your expected outcomes. 
- Clarify why other sources alone are insufficient.   

The bullet points are optional prompts to guide your response, you do not need to answer every one.

EVALUATION METHODS

- List the metrics and baseline data you will use to measure success. 
- Indicate the frequency of evaluations and who is responsible. 
- Explain how evaluation results will inform program adjustments. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

FOCUS AREAS & EXPERIENCE

United Way strives to stay closely connected to emerging trends in our focus areas, and we value partners who do the same. When we share what we’re learning with each other, we can spot new needs, discover opportunities, and grow together. 
We’d like to hear: 
- How you improve – the steps you take to make your services stronger and more effective. 
- Where you learn – the sources you rely on, such as professional networks, ongoing training, feedback from those you serve or your team, or collaboration with peer organizations. 
- A real example – a change you’ve made in the last few years based on research or feedback. 
- Your vision – if resources weren’t a barrier, what services would you enhance, who would you partner with, or what bold steps would you take? 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

COMMUNITY ENGAGEMENT

United Way is committed to building strong connections with the cities, towns, and neighborhoods across our region. We’re looking to partner with organizations that are experts in their field and deeply invested in their communities.  Please share:  
- Where you work – the specific areas or neighborhoods your organization serves. 
- How you stay connected – the ways you listen to and learn from the people in those communities (e.g., planning, research, events, ongoing conversations). 
- Your team’s community ties – such as living locally, speaking the languages of the community, or having deep cultural understanding. 
- Evidence of engagement – examples that show your connection, like increasing participation in programs, strong survey responses, or attendance at events. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

COLLABORATION

Collaboration is at the heart of lasting change, and many of our nonprofit partners bring valuable experience in working with others. Please tell us about one or two times when you teamed up with others. If you haven't been part of a collaboration, you can talk about what collaborations would be helpful in your area or how your organization has shared knowledge to help others. Here are some things to think about:  

- Tell us about collaborations you've been a part of, including what you were trying to achieve, what you did, and who you worked with. 
- What makes your organization want to join forces with others, and how do you decide if you should or not?  
- Share lessons learned from collaborations that changed your approach. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

ORGANIZATIONAL CAPACITY

Describe your agency’s capacity and expertise to deliver on this proposal. 
- Highlight key staff qualifications and volunteer involvement. 
- Explain how your organization ensures efficiency and cost-effectiveness. 

The bullet points are optional prompts to guide your response, you do not need to answer every one.

ORGANIZATIONAL VALUES

Describe how your organization and/or programs has worked to be culturally responsive to the target population and to be an inclusive environment for staff, volunteers, community partners, and clients. How are program participants involved in shaping the program, if applicable?

 
PROGRAM REVENUE specific to the program for which you seek funding 

 
PROGRAM EXPENSES specific to the program for which you seek funding 

• We have read and agree to the guidelines put forth in the UWSCI Partnership Agreement. 
• No events have occurred, and no facts have been discovered that would make the statements, including the financial information provided to UWSCI, materially inaccurate or misleading. We have accounted for all known or anticipated operating revenue and expenses in preparing our request. 
• We understand our grant may be reduced based on changes in available UWSCI funds, a reduction in our agency's services or outputs, or our inability to meet funding expectations.  
• Except as noted before, there are no outstanding fiscal, contractual, or legal issues that could impair our agency’s ability to fulfill our obligations under this proposal.