Welcome to Grant Warehouse
Information Collection Tool for Collaborative Partnerships:
Information Collection Tool for Collaborative Partnerships: Purpose- This form will assist with gathering information from coalitions or groups oforganizations that are going to collectively apply for a grant. This form will assist each partnering organization by providing a list of information specific to the collaboration and required by the funder, along with “return by” and “future meeting dates”.
Applicant and/or Collaborating Partner’s Contact Information:
Applicant Organization’s Name:
Address:
City: State: Zip:
Grant Contact Name: Title:
Phone: Email:
Website Other:
What role will your organization play:
Applicant Agency: Collaborating Partner: Other: Describe:
Partnering Organization’s Name:
Address:
City: State Zip:
Grant Contact Name: Title:
Phone: Email:
Website: Other:
What role will your organization play:
Applicant Agency: Collaborating Partner: Other: Describe:
**To add additional partners please go to last page.
II. Grant Funder’s Contact Information
Grantor’s Name:
Name of Grant:
Address:
City: State: Zip:
Funder’s Contact: Title:
Phone: Email:
Total Amount of Grant Funding: $ Total Number of Awards:
Estimated $ Range of Awards: $ to $
III. Project Name, Deadline(s), Award Amount, etc.
What is Your Project’s Name:
When is the grant proposal due?
IV. Applicant Eligibility
Has the applicant organization’s eligibility for this grant been verified?
Yes _____ No _____ If no, STOP and verify eligibility now.
Has the applicant organization received funding from grantor in the past?
Yes _____ No ______ If yes, complete the information below:
Grant Project Name:
Project Start Date and End Date: to
Total Amount of Grant:
Did the grant “close-out” with good standing with grantor? Yes ____ No ____
If no, please explain the issue:
*If required by grantor, the organization may be asked to provide a list of information for all closed grant projects.
Specific Grant Proposal Information:
How do the applicant’s organizational goals & objectives align with grantor’ s.
Provide a summary of the organization’s history, goals/objectives, key achievements, or issues being addressed.
Describe how the Organization’s program/project aligns with the grantor’s purpose statement?
What is the total amount of funding being requested?
What is the start date: and end date:
Will this project proposal require additional:
· Employees: Yes _____ No _____ If yes, how many?
· Building or office space: Yes _____ No _____. If yes, please describe?
· Administrators: Yes _____ No _____ If yes, please describe?
· Indirect Staff: Yes _____ No _____ If yes, please describe?
· Direct Programmatic Staff: Yes ______ No _____
· Accounting or Business Services: Yes ____ No ____ If yes, describe?
· Equipment
· Other: Yes _____ No _____ Please describe the expenditures & amounts:
For this grant, please describe the population(s) to be served.
What geographical areas) will be served?
Please break down:
Total number to be served:
Breakdown numbers by age, gender, race/ethnicity, income levels, disabilities, location, or other information pertinent to the proposed project:
Please describe the need(s) these grant funds will address.
How will the community be involved?
Describe the project plan, including goals and objectives.
Please list the goals, objectives, measurable outcomes, specific project activities, timelines and responsible individual or organization in a table format.
Please note: The Grantor may require a complete Work Plan that may include additional information such as timelines, responsible parties, etc.
Describe the Organization’s overall current programs and activities.
Describe how will this project be sustained after the grant has expired.
Identify program staff, volunteers and contractors who will be working on the proposed project. Please provide qualifications and/or education for each. Job descriptions may be required for new positions.
Are other organizations partnering on this project? Yes_____ No _____
If yes, please provide each organization’s name, address, phone, email address, fax number.
Provide a description of each partnering organization(s).
Include organization’s name, address, signatory contact information, grant contact information, tax status, mission statement, population served, brief history of capacity to manage grant funds and projects, and any other information you deem relevant.
Is the grantor requiring a MOU or other type of document between partners? Yes _____ No _____
If yes, please upload a copy of the signed and dated Memorandum of understanding.
What roles and responsibilities will the organization be tasked with for this grant.
Please include a budget and budget justification
Notes: