INNOVATION FUND ROUND 2Instructions for Online Application

General Instructions

1. The Application MUST BE COMPLETED IN A SINGLE SITTING. In other words, there is no opportunity to start, save, and return to finish your application. For this reason, we suggest

1. using the worksheet to complete and compile the entire application (especially any answers submitted as text); 2. assembling all the necessary attachments; and then 3. copying and pasting your answers into the appropriate sections of the online application form, and uploading all required and voluntary attachments in one sitting.

2. Text Answers. For paragraph answers, a short description on the type of information to be included appears next to the answer box for many (but not all) questions when that question is highlighted. Online, the word allowance and a word counter are found below the answer box. To assist in preparing the answers ahead of time, the same question description and allowance are found in worksheet below.

In addition, the online application form does not preserve any special formatting in text answers. Consequently, if applicant considers the format of a text answer helpful in conveying the communication’s content, it may save the answers to Q1 – Q4 (see worksheet below) as a PDF and submit that as an additional attachment. Note however, that the only permissible difference between the online answer and that in the PDF may be formatting, and word limits must be adhered to.

3. Uploading documents. When asked to upload a document there will be a ‘browse’ button next to the answer box that will allow you to search your computer system for the appropriate document. Please ensure that the computer used to fill out the application form has all the necessary attachments obtainable through this ‘browse’ function. All documents uploaded should be in pdf format.

4. On completion of the online application, applicants will receive a confirmation email. If you have technical difficulty in submitting the application or uploading documents, send an email to that effect to Innovation@afgg.org, indicating also a good phone number.

5. Dates and Times. Applications will be accepted until May 31, 2013 at 5 PM (EST).

6. Teleconference Call. AFGG will host a one-hour conference call at Noon (EST) on April 22, 2013, for any questions applicants might have regarding the RFP and the online application process. Advance registration for the call (accessible through the AFGG Innovation Fund Web Page) is required. Questions should be posed in writing by 5pm (EST) on April 18, 2013, at the same place as registration for the call. The list of questions raised will be circulated to all those registered no less than 24 hours before the call, together with relevant call-in information. Questions submitted after April 18, including those raised during the call, will be addressed on the call if time permits. Responses to questions not answered on the call will be addressed in a subsequent distribution.

7. Qualified Organizations. Before beginning the Application, please review the required characteristics of eligible applicants to be sure that you qualify.

An eligible organization has identified a clear strategy for mission-consistent revenue generating activity and conducted enough of the needed preliminaries (e.g., studies, technical assistance, market analysis, etc.) to have in place a mature strategy for execution, all as reflected in a solid business plan, so that Innovation Fund resources will be used for implementation.

An eligible organization also:

o is a 501(c)3 organization in the United States (including so called “friends of” and US fiscal agents for non-U.S. NGOs);

o is engaged in in areas of health, education, environment, poverty and/or world relations outside the United States;

o can demonstrate in quantitative terms the concrete impact it has made in addressing the problems it targets;

o can demonstrate organizational stability using information that might include but is not limited to: a) years of operation; b) relatively stable revenue; c) testimonial(s), e.g., from recurring donor(s); and/or d) cumulative impact;

o has had total revenue over the past five years that: averaged below $20,000,000, and above $5,000,000 per year, and derived in a significant part from at least one type of traditional funding

(e.g., charitable giving, government support, investment income); ando has quality systems of governance and financial accountability.

P a g e 2 o f 1 1 |

INNOVATION FUND ROUND 2 APPLICATION FORM WORKSHEET

The next pages track the online application. Since starting, saving, and resuming the application is not possible, applicants are encouraged to use this worksheet to prepare their application before commencing online entry, especially with respect to the text answers.

Applicant

Organization Name:

Address:

Phone Number:

Website:

Year established:

EIN #:

What is your relationship to the proposed initiative? (choose the one that is most applicable):

___ We’re the fiscal agent for the organization that will implement the initiative (i.e., the “Implementing Organization”).

___ We’re “Friends of” the Implementing Organization.___ Applicant is the Implementing Organization.

Leadership

Name of President/Exec Director:

Title

Email: Phone Number:

Name of Contact Person (if different):

Title:

Email: Phone Number:

Total number of Board members:

P a g e 3 o f 1 1 |

Program (The information sought relates to the general program of the organization that will implement the initiative (the "Implementing Organization")

What is the organization’s mission? (maximum 100 words)

Which areas listed below does the Implementing organization focus on:

___ Global Health ___ Environment

___ Education ___ Poverty

___ World Relations

Provide a brief description (including populations served) of the organization's work in these areas (maximum 200 words)

Which countries are the primary focus of this work?

P a g e 4 o f 1 1 |

Finance (The information sought relates to the general program of the organization that will implement the initiative (the "Implementing Organization")

Describe the Implementing Organization's current funding structureWhat traditional source(s) of revenue constitute a significant source of the organization's annual income, e.g., charitable giving, government support, investment income? (maximum 150 words)

Expenses & Income 2008-2012 in US $$ Enter numbers only

Year Expenses Income20082009201020112012

P a g e 5 o f 1 1 |

Proposed Initiative

What, if any, is the name of the proposed initiative?

From the list below, please indicate which of these focus areas the initiative will target:

___ Global Health ___ Environment

___ Education ___ Poverty

___ World Relations

Q 1: Provide an executive summary of the initiative (300 words maximum)

This should provide a clear distillation of the proposal and the essence of the business plan, including the most salient points elaborated in Q2 - Q4 below.

P a g e 6 o f 1 1 |

Q2: State the problem and the program goal (300 words maximum) (10 points)

What is the revenue generating or enhancing innovation or opportunity that will both produce a financial result and represent a value proposition for addressing the social need that is aligned with the mission of the organization?

What are the specific goals of the proposed innovation in terms of: financial need, accomplishment of mission, and impact of programs?

P a g e 7 o f 1 1 |

Q3: Describe the proposed initiative (1200 words maximum) (60 points)

[Note that the word limits do not apply to the material which may be uploaded in PDF in support of the business structure, e.g., projected Profit & Loss, Revenue Projections, Cost Structure, etc]

In many respects, this section of the application will resemble a business plan. Please describe the proposed innovation in detail, including (but not necessarily limited to) the following:

Products/services proposed and target market(s); Cost structure for product/service at start up and maturity; Plans and strategies for marketing, distribution, etc.; Revenue projections at startup and maturity (including unit profit on operations); Time projected to reach maturity and projected cash flow analysis until then; Implications of success to organization’s revenues at varying percentages of projections (e.g.,

what consequences would stem from the innovation being 50% successful, and what % of success makes the initiative financially worthwhile?);

Potential “choke points” (e.g., what could go wrong? What risks does the innovation present?); Assessments or studies (e.g., market studies) undertaken to date to determine the viability of the

proposed innovation, summarizing evidence that the innovation will produce the desired sustainable result, as well as contribute to program impact;

The relationship between the model proposed and the organization’s finances—ie., the likely impact on both the financial structure and stability of the organization, taking into account the organization’s current financial structure;

Any upside leverage beyond the immediate impact on organization and any potential risks other than to the organization.

P a g e 8 o f 1 1 |

Q4: Relevant experience and capacities (300 words maximum) (30 points)

Who is going to run the initiative? What percentage of their time will this occupy? What background or qualifications do they bring to the tasks? Who on the organization’s board and/or advisory committee is knowledgeable or experienced in activity related to the initiative? (Applicants may include short bio(s), no more than 150 words, of key personnel outlining relevant experiences or skills).

What previous or current organizational experience exists with developing and managing revenue diversification schemes and/or applying such innovations to program design and implementation?

What existing assets of the organization (e.g., geographic scope, skills, systems, market reach, social media presence, etc.) will be employed in implementing the innovation?

P a g e 9 o f 1 1 |

Documents to upload

Required:

List of Current Board Members with employment affiliation (if any); 501(c)(3) letter granting tax exemption from the U.S. Department of the Treasury; Budget for use of the requested grant and required matching funds; Material supporting business proposal, e.g., projected Profit & Loss, Revenue

Projections, Cost Structure, etc. Most recent financial statements (audited statements are preferred but not required); Authorization statement signed by Chief Executive of the organization, Chief Financial

Officer, and Board Chair (please sign, scan and upload the authorization statement on the next page)

;Optional:

Commitment letter from known co-funding source(s) (if any) to fulfill match goal Material demonstrating Applicant’s stability (e.g., a) years of operation of the

organization’s activities; b) relatively stable revenue; c) testimonial(s), particularly from recurring donor(s); and/or d) cumulative impact;)

Relevant biographies of key personnel PDF of any o r all of Q1 – Q4 to preserve formatting

Note: After you "submit" the online application, it may take a little while for the entire application to be uploaded. Be patient. But after a reasonable time, if nothing happens, contact us at innovation@afgg.org, and we'll check to see if the application was received (lack of notice notwithstanding). Thanks.

P a g e 1 0 o f 1 1 |

Authorization Statement:

The undersigned _______________________________ is the ___________________ of [print name] [print title]

___________________________________, the organization submitting the attached [print organization legal name]

Application to the Alliance for Global Good Innovation Fund. By my signature below, I confirm

that I am authorized by law and the governing documents of the organization, to submit this

application and make the representations set forth herein.

_______________________________________[Signature]

Dated:

By our signatures below, we confirm the statement set forth above:

_______________________________________[Signature]

_______________________________________[Print Name]

_______________________________________[Print Title]

_______________________________________[Signature]

_______________________________________[Print Name]

_______________________________________[Print Title]

P a g e 1 1 o f 1 1 |