Agencies with annual budgets of $20,000 or more

Application for 2025-2027 Funding

For Agencies with Annual Budgets Over $20,000
Full Legal Name of Organization*
Mailing Address*

Mailing Address

CityState

Zip Code
Physical Address

Street Address

Street Address Line 2

CityState

Zip Code
Name of CEO/ Executive Director*

First NameLast Name
Title*
Phone Number*

Area CodePhone Number
E-mail*
Name of Contact Person (if different from above)

First NameLast Name
Title
Phone Number

Area CodePhone Number
E-mail
Total Amount Requested for All Programs*
Is the Organization a 501 (c)(3)*

YesNo
Year Established*
Year organization began providing services in Matagorda County*
Year organization began providing services in Wharton County*
Federal Employer Identification Number*
Total Number of Board Members*
Total Number of Staff*
Total Number of Volunteers*
Organizational Mission Statement*

0/200
Brief Description of Organization*

0/300
List All Current Programs of Organization*
Population Served by Organization*
Include number, age groups, race & ethnicity, income levels, counties of resident, etc. (provide actual data or best estimates if data is not collected.)

Organization Management
Please describe any significant changes in the organization's board or management during the past year.*
What is the role of the Board in your organization?*
Number of board members prescribed by the bylaws?*
Number of board members currently on the board?*
Number of board meetings per year required by the bylaws?*
Number of board meetings held last year? *
Average attendance at board meeting?*
No. of current board members making financial contributions to the organization since the most recently completed fiscal year.*

Organization Budget
Please insert the income and expense budget for the entire organization, not just the program(s) for which you are requesting funding. Organizations that are national in scope, or serve a geographic area greater than Matagorda and Wharton counties from one central regional or area office, please include the budget for the national organization or the central regional or area office. If you also have a separate budget solely covering Matagorda and Wharton counties, please include that budget as well.
Organization Budget*

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Organization Budget Narrative

Budget for entire organization, not single program only.
Please explain any changes of 10% or more in the revenue line items from the current year's budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the organization's total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations. *

Program Budget
Please insert the income and expense budget for the program for which you are requesting funding only. If you are requesting funding for more than one program, please prepare a separate Budget and a separate Program Budget Narrative for each program. You will have an opportunity to upload each budget individualy.
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Program Budget Narrative

Budget for program only
Explain any major changes in the program revenue line items from the current year budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the programs total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations.*
Explain how you intend to fund any program deficit.*

Please indicate the unduplicated number of people served by the program during the previous year. (As example, if one person comes to your center five times for meals, count it as one person. Later you can include five meals when counting meals served.) If this is a new program, please estimate the number of people you anticipate serving the first year.)
Bay City*
Blessing*
Cedar Lake*
Cedar Lane*
College Port*
El Maton*
Markham*
Matagorda*
Midfield*
Palacios*
Pledger*
Sargent*
Sugar Valley*
Van Vleck*
Wadsworth*
Other*
Specify other:
TOTAL MATAGORDA COUNTY*
Bonus*
East Bernard*
Egypt*
El Campo*
Glen Flora*
Hillje*
Hungerford*
Lissie*
Louise*
New Gulf*
Pierce*
Wharton*
Other*
Specify other:
WHARTON COUNTY TOTAL*
List most recent grants received from the Matagorda County United Way*

Program Success Story
Please share a success story (from the past 24 months) that illustrates how this program is making an impact on Matagorda and/or Wharton counties. Please do not use more than one page.*
Please share pictures or other documents that illustrate how this program is making an impact on Matagorda and/or Wharton counties.

Browse Files
Optional. You can use this to upload multiple files but the total amount of data must be 100MB or less. Cancelof
Do you wish to add another program to this application?*

YesNo

Program Budget
Please insert the income and expense budget for the program for which you are requesting funding only. If you are requesting funding for more than one program, please prepare a separate Budget and a separate Program Budget Narrative for each program. You will have an opportunity to upload each budget individualy.
Upload a File

Cancelof
Program Budget Narrative

Budget for program only
Explain any major changes in the program revenue line items from the current year budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the programs total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations.*
Explain how you intend to fund any program deficit.*

Please indicate the unduplicated number of people served by the program during the previous year. (As example, if one person comes to your center five times for meals, count it as one person. Later you can include five meals when counting meals served.) If this is a new program, please estimate the number of people you anticipate serving the first year.)
Bay City*
Blessing*
Cedar Lake*
Cedar Lane*
College Port*
El Maton*
Markham*
Matagorda*
Midfield*
Palacios*
Pledger*
Sargent*
Sugar Valley*
Van Vleck*
Wadsworth*
Other*
Specify other:
TOTAL MATAGORDA COUNTY*
Bonus*
East Bernard*
Egypt*
El Campo*
Glen Flora*
Hillje*
Hungerford*
Lissie*
Louise*
New Gulf*
Pierce*
Wharton*
Other*
Specify other:
WHARTON COUNTY TOTAL*
List most recent grants received from the Matagorda County United Way

Program Success Story
Please share a success story (from the past 24 months) that illustrates how this program is making an impact on Matagorda and/or Wharton counties. Please do not use more than one page.*
Please share pictures or other documents that illustrate how this program is making an impact on Matagorda and/or Wharton counties.

Browse Files
Optional. You can use this to upload multiple files but the total amount of data must be 100MB or less. Cancelof
Heading
Do you wish to add another program to this application?*

YesNo

Program Budget
Please insert the income and expense budget for the program for which you are requesting funding only. If you are requesting funding for more than one program, please prepare a separate Budget and a separate Program Budget Narrative for each program. You will have an opportunity to upload each budget individualy.
Upload a File

Cancelof
Program Budget Narrative

Budget for program only
Explain any major changes in the program revenue line items from the current year budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the programs total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations.*
Explain how you intend to fund any program deficit.*

Please indicate the unduplicated number of people served by the program during the previous year. (As example, if one person comes to your center five times for meals, count it as one person. Later you can include five meals when counting meals served.) If this is a new program, please estimate the number of people you anticipate serving the first year.)
Bay City*
Blessing*
Cedar Lake*
Cedar Lane*
College Port*
El Maton*
Markham*
Matagorda*
Midfield*
Palacios*
Pledger*
Sargent*
Sugar Valley*
Van Vleck*
Wadsworth*
Other*
Specify other:
TOTAL MATAGORDA COUNTY*
Bonus*
East Bernard*
Egypt*
El Campo*
Glen Flora*
Hillje*
Hungerford*
Lissie*
Louise*
New Gulf*
Pierce*
Wharton*
Other*
Specify other:
WHARTON COUNTY TOTAL*
List most recent grants received from the Matagorda County United Way

Program Success Story
Please share a success story (from the past 24 months) that illustrates how this program is making an impact on Matagorda and/or Wharton counties. Please do not use more than one page.*
Please share pictures or other documents that illustrate how this program is making an impact on Matagorda and/or Wharton counties.

Browse Files
Optional. You can use this to upload multiple files but the total amount of data must be 100MB or less. Cancelof
Do you wish to add another program to this application?*

YesNo

Program Budget
Please insert the income and expense budget for the program for which you are requesting funding only. If you are requesting funding for more than one program, please prepare a separate Budget and a separate Program Budget Narrative for each program. You will have an opportunity to upload each budget individualy.
Upload a File

Cancelof
Program Budget Narrative

Budget for program only
Explain any major changes in the program revenue line items from the current year budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the programs total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations.*
Explain how you intend to fund any program deficit.*

Please indicate the unduplicated number of people served by the program during the previous year. (As example, if one person comes to your center five times for meals, count it as one person. Later you can include five meals when counting meals served.) If this is a new program, please estimate the number of people you anticipate serving the first year.)
Bay City*
Blessing*
Cedar Lake*
Cedar Lane*
College Port*
El Maton*
Markham*
Matagorda*
Midfield*
Palacios*
Pledger*
Sargent*
Sugar Valley*
Van Vleck*
Wadsworth*
Other*
Specify other:
TOTAL MATAGORDA COUNTY*
Bonus*
East Bernard*
Egypt*
El Campo*
Glen Flora*
Hillje*
Hungerford*
Lissie*
Louise*
New Gulf*
Pierce*
Wharton*
Other*
Specify other:
WHARTON COUNTY TOTAL*
List most recent grants received from the Matagorda County United Way

Program Success Story
Please share a success story (from the past 24 months) that illustrates how this program is making an impact on Matagorda and/or Wharton counties. Please do not use more than one page.*
Please share pictures or other documents that illustrate how this program is making an impact on Matagorda and/or Wharton counties.

Browse Files
Optional. You can use this to upload multiple files but the total amount of data must be 100MB or less. Cancelof
Do you wish to add another program to this application?*

YesNo

Program Budget
Please insert the income and expense budget for the program for which you are requesting funding only. If you are requesting funding for more than one program, please prepare a separate Budget and a separate Program Budget Narrative for each program. You will have an opportunity to upload each budget individualy.
Upload a File

Cancelof
Program Budget Narrative

Budget for program only
Explain any major changes in the program revenue line items from the current year budget to the proposed budget.*
If a there is an expense line item of "other revenue" of 10% or more of the organization's total revenue, provide a description of the revenue sources included in this line item.*
Explain any changes of 10% or more in the expense line items from the current year's budget to the proposed budget.*
If the miscellaneous and/or other expense line item includes 5% or more of the programs total expenses, provide a description of the expenses included in this line item.*
Explain what contributions are included in the in-kind donations.*
Explain how you intend to fund any program deficit.*

Please indicate the unduplicated number of people served by the program during the previous year. (As example, if one person comes to your center five times for meals, count it as one person. Later you can include five meals when counting meals served.) If this is a new program, please estimate the number of people you anticipate serving the first year.)
Bay City*
Blessing*
Cedar Lake*
Cedar Lane*
College Port*
El Maton*
Markham*
Matagorda*
Midfield*
Palacios*
Pledger*
Sargent*
Sugar Valley*
Van Vleck*
Wadsworth*
Other*
Specify other:
TOTAL MATAGORDA COUNTY*
Bonus*
East Bernard*
Egypt*
El Campo*
Glen Flora*
Hillje*
Hungerford*
Lissie*
Louise*
New Gulf*
Pierce*
Wharton*
Other*
Specify other:
WHARTON COUNTY TOTAL*
List most recent grants received from the Matagorda County United Way

Program Success Story
Please share a success story (from the past 24 months) that illustrates how this program is making an impact on Matagorda and/or Wharton counties. Please do not use more than one page.*
Please share pictures or other documents that illustrate how this program is making an impact on Matagorda and/or Wharton counties.

Browse Files
Optional. You can use this to upload multiple files but the total amount of data must be 100MB or less. Cancelof

Attachments
A List of the members of of your organizations governing body, including professional, business and community affiliations. Indicate any paid staff members serving on the board.

Upload a File

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List members if you do not want to upload.
Financial Statements (from the most recently completed audit or review)*

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Management letter and agency response (from the most recently completed audit or review)*

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Most recent Annual Report (if applicable)

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General Liability Insurance Policy (cover sheet showing period of coverage and policy limit is sufficient)*

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A completed, signed Anti-Terrorism Compliance Measures Form*

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Non-Discrimination Policy*

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Organizations most recent IRS 990 or its equivalent
Most 990s will be to large to upload please print and 3-hole punch. You will need to submit them in person or by mail.
Permanent File Attachments

Upload the following documents ONLY if you are a NEW partner agency OR your agency has updated the item listed since your previous application.
Articles of Incorporation or Certificate of Formation

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Organization's By-Laws

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Most Recent 501(c)(3) tax exempt letter

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Strategic Plan (if applicable)

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I certify that to the best of my knowledge and belief the information contained in this proposal for funding is true and correct and that I am duly authorized by the governing body of this organization to sign and submit this proposal for funding
Date*

MonthDayYear
Name*

First NameLast Name
Title*
Signature*
Should be Empty:

Application for 2025-2027 Funding

Financial Information

Organization Management

Organization Budget

Organization Budget Narrative

Program Budget

Program Budget Narrative

Program Information

Program Success Story

Program Budget

Program Budget Narrative

Program Information

Program Success Story

Heading

Program Budget

Program Budget Narrative

Program Information

Program Success Story

Program Budget

Program Budget Narrative

Program Information

Program Success Story

Program Budget

Program Budget Narrative

Program Information

Program Success Story

Partnering with United Way

Attachments

Permanent File Attachments