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Community Impact Grant - Letter of Intent

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Community Impact Grant - Letter of Intent

Community Impact Grant - Letter of Intent

Has the program been in existence for a minimum of two years?

Yes

No

Information

Who is the Executive Director?

How long has the Executive Director served?

Program Contact

Name (First & Last)

Email

Phone

Organizational Overview

Name of Organization

Name of Program

Organization Website

EIN

Has your organization ever partnered with United Way of Martin County? (check all that apply)

Volunteer

Donor/Supporter

None of the above

Other (please explain)

Enter other…

Does total revenue exceed $500,000?

Yes

No

Does your organization have an independent financial audit?

Yes

No

Does your agency have a financial review and submit an IRS Form 990?

Yes

No

Program Overview

What Impact Area are you applying for?

Education

Health

Financial Stability

Select your program's focus area in education:

SCHOOL READINESS: Children will receive a balanced literacy approach to learning that contributes to kindergarten readiness

EARLY GRADE SUCCESS: Students are reading at grade level by the end of third grade. Students have acquired the skills for academic and social-emotional development.

MIDDLE SCHOOL SUCCESS: Students have acquired the skills for academic and social-emotional development.

HIGH SCHOOL AND POST-SECONDARY SUCCESS: Students graduate or complete high school with a post-secondary plan in place or are prepared for work.

NOT APPLICABLE

Select your program's focus area in financial stability:

ECONOMIC SELF SUFFICIENCY: Individuals/families have access to food, shelter, education and other income/work supports

EMPLOYMENT SUPPORT: Individuals have access to Jobs/Job Training and health and education initiatives that improve employability and retention

FINANCIAL MANAGEMENT AND SUPPORT: Individuals Increase financial management knowledge and skills.

NOT APPLICABLE

Select your program's focus area in health:

ACCESS TO HEALTH CARE: Individuals have access to necessary health care services- including those for preventative, mental, dental, pharmaceutical, vison- provided in a coordinated way that will produce the best health results.

HEALTHY BEGINNINGS TO LIFE: Women & children receive appropriate prenatal, well-being and pediatric care.

HEALTHIEST LIFESTYLE: All individuals are eating healthy, are physically active and maintain a healthy weight.

HEALTHY RELATIONSHIPS: Individuals have a positive outlook and engage in supportive relationships.

NOT APPLICABLE

Estimated Range of Funding Requested from United Way

$

Note: United Way funding is intended to support, not fully fund, program costs. Applicants must demonstrate additional funding sources.

Describe the program and how it will address a need within the stated impact area.

Include Target Population, specific geographic area impacted/served, County, zip code, neighborhood) (2500 words or less)

How are you currently measuring the success of the program?

Please list any other funders for this program

Sorry, but programs must be in existence for 2 years before receiving funding.

Sorry, but organizations must have an independent financial audit to continue.

Sorry, but organizations must have an IRS Form 990 to continue.

Leave this field blank

Our mission is to improve the education, health and financial security in Martin County.

Contact

10 SE Central Parkway, Ste 101
Stuart, FL 34994

772-283-4800

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