instructions: organization information copy reference · for the budget template, please fill out...

COMMUNITY GRANTMAKING – REFERENCE APPLICATION

______________________________________________________________________________ of 17 Account Registration

ACCOUNT REGISTRATION ______________________________________________________________________________ Instructions: Please enter your organization and contact information in the form below.

Organization Information * Organization Name:

AKA/DBA:* Address:

Address 2:* City:* Country:* State:* Postal Code:* EIN Number:* Phone:

Fax:* Website:* Organization Email Address:* Year Established:* Mission Statement: [50 word limit]* Summary of organization’s history, programs and services: [500 word limit]

Contact Information * Prefix:* First Name:* Last Name:

Suffix:* Email:* Title:* Direct Line:

Direct Line Ext.:Mobile Number:

* Address:Address 2:

* City:* State:* Country:* Postal Code:______________________________________________________________________________REFERENCE C

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______________________________________________________________________________ of 17 Eligibility Quiz

ELIGIBILITY QUIZ ______________________________________________________________________________ Instructions: The Annenberg Foundation gives priority to nonprofit organizations serving the Los Angeles, Ventura, Orange, Riverside and San Bernardino Counties that are well-integrated into the fabric of the communities they serve. In addition, we evaluate whether an organization has established best practices as it relates to diversity, financial sustainability, infrastructure, board governance, staff development, programs & services, collaboration and networks with peers.

The Annenberg Foundation receives considerably more requests for funding than we can support. Only those requests that effectively address our grantmaking guidelines and our Board of Directors’ priorities will be considered. Please answer all of the quiz questions so that we may accurately assess your eligibility.

Eligibility Quiz * Are you a 501(c)(3) organization or have a fiscal sponsor?☐Yes ☐No

* Have you been serving the Greater Los Angeles Five-County Region for at least three years?Los Angeles 5-County Region☐Yes ☐No

* Has your organization submitted an LOI and has been declined or received a grant from theAnnenberg Foundation in the last 12 months?☐Yes ☐No

______________________________________________________________________________

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https://www.annenberg.org/sites/default/files/5countymap.pdf


* In the LOI application, applicants have the option to upload their budget using the Annenberg Excel file or the online budgettemplate. If the LOI is approved, applicants will be required to fill out the online budget template in the Full Application.

______________________________________________________________________________ of 17 LOI Application

LOI APPLICATION ______________________________________________________________________________ Introduction: Welcome to the Annenberg Foundation's online community grantmaking LOI. Instructions and additional information are available below. We highly recommend that you carefully review the reference copy of the online LOI located on the Annenberg Foundation’s website and prepare all required documents prior to starting the LOI process.

Before beginning the LOI, please be sure to view our Grantmaking Guidelines. The guidelines will help you understand how the Annenberg Foundation will assess your proposal. Our full proposal grant application asks questions specifically related to these guidelines. Make sure to address each of the aspects of our guidelines in your LOI as well.

We accept LOIs on a rolling basis. Upon submission, you will receive an email from the Foundation confirming receipt. If your LOI passes our initial review, you will be invited to submit a full proposal application.

Required documents for submitting an LOI:1. Budget Template*2. Audited Financial Statements (most recently completed fiscal year) OR Unaudited Financial

Statements (most recently completed fiscal year) for Applicant Organization3. IRS Form 990 (if not currently on GuideStar)

CURRENT AND RETURNING GRANTEES: Grants are generally awarded for a one-year Grant Period. Returning grantees are eligible to reapply for funding after the current Grant Period ends and the final report is submitted and approved by the Foundation.

Nonprofits that have received two consecutive grants must wait twelve months from the end of their second grant period before applying for a new grant.

Typically, general operating support grants are not greater than ten percent of the total organization budget.

Organizations with budgets greater than $10 million are ineligible for general operating support, but can apply for project support. Organizations with budgets less than $10 million are eligible for either project or general operating support.

FISCALLY SPONSORED ORGANIZATIONS: Please fill out the LOI based on information for the applicant organization. Further information may be requested at a later date on the fiscal sponsor.

NATIONAL ORGANIZATIONS: Please fill out the LOI with information pertinent to the local or regional office carrying out the work in the Los Angeles region. For the budget template, please fill out the “Organization Budget” section with information for the national organization and include a local budget for the Los Angeles work in the “Project Budget” section. Further information may be requested at a later date on the national organization.

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ORGANIZATION INFORMATION * Organization Name:

AKA/DBA:* Address:

Address 2:* City:* Country:* State:* Postal Code:* EIN Number:* Phone:

Fax:* Website:* Organization Email Address:* Year Established:* Mission Statement: Limit statement to 50 words or less* Summary of organization’s history, programs and services: Limit statement to 500 words or less* Fiscal Year End Date:* Total Income for the Most Recently Completed Fiscal Year:* Total Expenses for the Most Recently Completed Fiscal Year:* Current Fiscal Year Organization Income:* Current Fiscal Year Organization Expenses:

If expenses exceeded income for the most recently completed fiscal year, please explain thereason for the deficit and how the organization is addressing the shortfall: Top Three Private Funding Sources:

Name of Funder Grant Amount Date Received Date End Project Specific? Funder 1 Funder 2 Funder 3

* Audited Financial Statements (most recently completed fiscal year) OR unaudited financialstatements (most recently completed fiscal year) for applicant organization: [Upload]* Does your organization have a fiscal sponsor?☐Yes ☐No

If Yes: * Fiscal Sponsor Name:

AKA/DBA:* Address:

Address 2:* City:* State:* Zip Code:* EIN Number:* Contact Name:* Contact Phone Number:

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* Is your fiscal sponsor's most recent Form 990 available on Guidestar? ☐Yes ☐No If No: * Please upload the most recently completed IRS Form 990. [Upload]

* Please upload your fiscal sponsor's audited financials. [Upload] * Please upload your fiscal sponsor's list of Board of Directors/Trustees. [Upload] * Please upload your fully executed fiscal sponsorship agreement. [Upload]

If No: * Is your organization's most recent Form 990 available on Guidestar? ☐Yes ☐No * Please upload the most recently completed IRS Form 990. [Upload]

CONTACT INFORMATION

Primary Contact for Request * Prefix: * First Name: * Last Name: Suffix: * Title: * Phone Number: Extension: * Email: Primary Contact for Organization This should be the organization’s highest-ranking employee.

* Same as Request Contact? ☐Yes ☐No * Prefix: * First Name: * Last Name: Suffix: * Title: * Phone Number: Extension: * Email: Contact Information for Board Chair * Prefix: * First Name: * Last Name: Suffix: * Title: * Organization

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Agreement Signatory Contact information for the person responsible for signing the Grant Agreement.

* Prefix: * First Name: * Last Name: Suffix: * Title: * Phone Number: Extension: * Email:

GRANT REQUEST INFORMATION Grant Request * Request Amount: * Primary County Served: [Los Angeles, Orange, Riverside, San Bernardino, Ventura] Other Counties Served: * General Operating Support or Project Support: ☐ General Operating Support ☐ Project Support

If Project Support: * Project Title: * Description of Grant Request: Limit statement to 1,000 words or less

Provide a detailed program description, including geographic focus area, target population and numbers served, specific use of funds, timeline, as well as whether it is new or existing effort of the organization. For GOS requests, provide a description of why you are requesting unrestricted support and why it is needed now. Sample Project Description: Grant funds will be used for the After-School Program, now in its seventh year of programming, which provides homework assistance and recreation opportunities. The Program annually serves 3,000 at-risk high-school students from 12 schools throughout Los Angeles, 90% of whom graduate from high school as a result of the program. College student volunteers are recruited and trained to act as mentors and serve as role models through regular meetings. Thus, the Program strives to improve students’ lives both academically and socially. The funds requested will be used to pay for mentor stipends.

* Projected Goals and Outcomes: Limit statement to 500 words or less Feedback We welcome your overall feedback on the online LOI application. Limit statement to 250 words or less Please review the entire LOI before submitting. Upon submission, you will receive an email confirming the Foundation's receipt of your application. After a careful review of the LOI, you can expect a response from the Foundation within six weeks. The most competitive LOIs will be invited to submit a full proposal application online. If your LOI is declined, your organization will be eligible to re-apply 12 months from the declination date. Due to the high volume of LOIs submitted on a daily basis, staff may not be able to provide tailored feedback on declined LOIs. ______________________________________________________________________________

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______________________________________________________________________________ of 17 Full Application

FULL APPLICATION ______________________________________________________________________________ Instructions: Welcome to the Annenberg Foundation's online community grantmaking full proposal application. We highly recommend that you carefully review the reference copy of the full proposal grant application and prepare all required documents prior to starting the application process.

Our online grant application asks questions about leadership and governance that may require input from your leadership team. A reference copy is available for your review prior to completing the application. Please note the word limits for some of the responses.

Required documents for submitting a full application: • Diversity Questionnaire • Board Give and Get Template • Organizational Chart • Private Funding Sources Template

ORGANIZATION INFORMATION Some fields auto-populated from LOI

* Organization Name: AKA/DBA: * Address: Address 2: * City: * Country: * State: * Postal Code: * EIN Number: * Phone: Fax: * Website: * Organization Email Address: * Year Established: * Mission Statement: Limit statement to 50 words or less * Summary of organization’s history, programs and services: Limit statement to 500 words or less * Fiscal Year End Date: * Total Income for the Most Recently Completed Fiscal Year: * Total Expenses for the Most Recently Completed Fiscal Year: * Current Fiscal Year Organization Income: * Current Fiscal Year Organization Expenses:

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If expenses exceeded income for the most recently completed fiscal year, please explain the reason for the deficit and how the organization is addressing the shortfall: Top Three Private Funding Sources: Name of Funder Grant Amount Date Received Date End Project Specific? Funder 1 Funder 2 Funder 3

* Private Funding Sources Template [See Templates] * Audited Financial Statements (most recently completed fiscal year) OR unaudited financial statements (most recently completed fiscal year) for applicant organization: [Upload] * Organizational chart [Upload] * Does your organization have a fiscal sponsor? ☐Yes ☐No

If Yes: * Fiscal Sponsor Name: AKA/DBA: * Address: Address 2: * City: * State: * Zip Code: * EIN Number: * Contact Name: * Contact Phone Number: * Is your fiscal sponsor's most recent Form 990 available on Guidestar?

☐Yes ☐No If No: * Please upload the most recently completed IRS Form 990. [Upload]

* Please upload your fiscal sponsor's audited financials. [Upload] * Please upload your fiscal sponsor's list of Board of Directors/Trustees. [Upload] * Please upload your fully executed fiscal sponsorship agreement. [Upload]

If No: * Is your organization's most recent Form 990 available on Guidestar? ☐Yes ☐No * Please upload the most recently completed IRS Form 990. [Upload]

CONTACT INFORMATION

All fields auto-populated from LOI Primary Contact for Request * Prefix: * First Name: * Last Name: Suffix:

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* Title: * Phone Number: Extension: * Email: Primary Contact for Organization This should be the organization’s highest-ranking employee.

* Same as Request Contact? ☐Yes ☐No * Prefix: * First Name: * Last Name: Suffix: * Title: * Phone Number: Extension: * Email: Contact Information for Board Chair * Prefix: * First Name: * Last Name: Suffix: * Title: * Organization Agreement Signatory Contact information for the person responsible for signing the Grant Agreement.

* Prefix: * First Name: * Last Name: Suffix: * Title: * Phone Number: Extension: * Email:

LEADERSHIP PROFILE Leadership Profile * Please explain any recent changes (within the last year) in leadership at the President, CEO, Executive Director or Board Chair level (enter n/a if there has not been a leadership change). Limit statement to 150 words or less * Describe the background and experience of the President, CEO or Executive Director. Limit statement to 150 words or less

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* Describe the background and experience of the Board Chair. Governance * Number of Board Members: * Do you have a “Give and Get” policy for Board Members? ☐Yes ☐No

If Yes: * Please indicate the amount required by each board member. If No:

* Please explain. * Board Give and Get Template [See Templates] * What percentage of the annual budget was raised by the Board from outside sources during the most recently completed fiscal year: Do not include the amounts personally contributed by Board Members. If no contributions were raised within the last year enter 0.

* Please enter the amount that members of the Board personally contributed during the most recently completed fiscal year: * Please enter the percentage of Board Members engaged in fundraising (do not list the number of Board Members): * What critical relationships and resources do Board members bring to help the organization fulfill its mission? Please describe specific strategies the Board utilizes to fundraise for the organization. What have the outcomes been due to these efforts? Limit statement to 200 words or less

DIVERSITY * What diversity challenges does your organization face in its work overall? What kinds of resources or assistance does your organization need to meet these challenges? Limit statement to 250 words or less * What forms of diversity do you think are important for strengthening the quality of your work proposed and why? Limit statement to 250 words or less * Diversity Questionnaire Template [See Templates]

GRANT REQUEST INFORMATION Some fields auto-populated from LOI

Grant Request * Request Amount: * Primary County Served: [Los Angeles, Orange, Riverside, San Bernardino, Ventura] Other Counties Served: * General Operating Support or Project Support: ☐ General Operating Support ☐ Project Support If Project Support: * Project Title: * Description of Grant Request: Limit statement to 1,000 words or less

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Provide a detailed program description, including geographic focus area, target population and numbers served, specific use of funds, timeline, as well as whether it is new or existing effort of the organization. For GOS requests, provide a description of why you are requesting unrestricted support and why it is needed now. Sample Project Description: Grant funds will be used for the After-School Program, now in its seventh year of programming, which provides homework assistance and recreation opportunities. The Program annually serves 3,000 at-risk high-school students from 12 schools throughout Los Angeles, 90% of whom graduate from high school as a result of the program. College student volunteers are recruited and trained to act as mentors and serve as role models through regular meetings. Thus, the Program strives to improve students’ lives both academically and socially. The funds requested will be used to pay for mentor stipends.

* Projected Goals and Outcomes: Limit statement to 500 words or less * Provide evidence regarding client demand/need for service. Explain, if any, the potential for systemic change with your approach. If requesting GOS, please answer this question in the context of the overall organizational mission. Limit statement to 400 words or less * What is innovative about your proposed solution, service model, or project/program delivery, and how does this innovation help you have a greater impact with your services? Tell us how your services have more impact than others doing similar work in your field. Limit statement to 400 words or less If requesting project support, please explain if the organization is partnering with another agency for this project, program, or service delivery. If requesting GOS, please provide an explanation of who your key partners are to carry out your mission. Limit statement to 200 words or less * Please list up to three program objectives in concrete, measurable terms, including expected outcomes that provide evidence of the impact of your methodology. Limit statement to 400 words or less * Describe how the above objectives/outcomes are measured and monitored. What reports are produced and available to inform senior staff and board members of program achievements, as well as any refinements that are needed? Limit statement to 400 words or less If a grant from the Annenberg Foundation will help the organization fulfill a matching grant from another funder, please describe below. If not, please enter n/a. Limit statement to 150 words or less Innovation and Partnerships * How does the organization stay connected to community needs to ensure that services remain relevant? Limit statement to 250 words or less * Please describe any membership organizations, task forces, coalitions, or other groups in which the organization participates that are relevant for creating systemic change in your service model. Limit statement to 250 words or less * What makes the organization competitive or unique in the community? Limit statement to 250 words or less

FINANCIAL SUSTAINABILITY Financial Sustainability * Project Budget [Only required for Project requests; See Templates] * Organizational Budget [See Templates]

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* Describe specific actions and/or plans the board and staff will take to ensure the project/program will remain financially sustainable. If requesting GOS, please describe. Limit statement to 250 words or less If expenses exceeded income for the most recently completed fiscal year, please explain the reason for the deficit and how the organization is addressing the shortfall. * Do you have a Board designated cash reserve? ☐Yes ☐No

If Yes: * Please specify how much is set aside as Board designated cash reserve? * Please explain how this figure was determined. Limit statement to 150 words or less

Feedback We welcome your overall feedback on the full proposal application. Limit statement to 250 words or less Please review the entire application before submitting. Upon submission, you will receive an email confirming the Foundation's receipt of your application. After a careful review of the full proposal, a member of our program team will reach out to schedule a phone or site visit with your Executive Director and Board Chair. The Annenberg Foundation will communicate a decision about your proposal when the programmatic review and due diligence process is complete. Grant decisions are subject to Board-adopted guidelines and approval. ______________________________________________________________________________

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______________________________________________________________________________ of 17 Sample Templates

Private Funding Sources Template ACTIVE Funder Project (specific to this

request) General Support Date – Receipt Date – End

PENDING Funder Project (specific to this


PLAN ON SUMBITTING Funder Project (specific to this


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Board Give and Get Template

Board Member

Give (Previous FY)

Get (Previous FY)

Total (Previous FY)

Give (Current FY)

Get (Current FY)

Total (Current FY)

Total

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Diversity Questionnaire Template RACIAL/ETHNIC IDENTIFICATION Racial/Ethnic Identification

# of People Served by Organization

% of People Served by Organization

# of People Served by Project (if applicable)

% of People Served by Project (if applicable)

# of Volun-teers

# of People on Staff

# of People on Board of Directors

African American/Black

Asian/Asian Americanⁱ

Hispanic/Latino Native American or Alaska Nativeⁱ

Native Hawaiian or Other Pacific Islanderⁱ

White/Caucasianⁱ Two or More Races

Unknown TOTAL GENDER GENDER # of People

Served by Organization




# of Volun-teers



Female Male Unknown/ Does Not Identify as Male or Female

LGBTQIA





# of Volun-teers



LGBTQIAⁱⁱ

DISABILITY





# of Volun-teers



Disabilityⁱⁱ ⁱNot Hispanic or Latino ⁱⁱIn completing these sections, please use self-identified data only

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Organizational Budget Template

Current FYE (mo/yr) Next FYE (mo/yr) Revenue Revenue Current FY ($) Current FY (%) Next FY ($) Next FY (%) Individual Contributions (Major Gifts)

Foundation Grants Corporate Grants Government Grants Government Contracts Earned Income Development/Fundraising Revenue

Other Total Expenses Salaries For Salaries, list staff positions FTE PT. Position Current FY ($) Current FY (%) Next FY ($) Next FY (%) Total Current FY ($) Current FY (%) Next FY ($) Next FY (%) Total Taxes and Benefits Operating Costs Operating Costs include Staff Development, Rent, Utilities, Mileage, Parking, Audit/Tax Fees, Non-capital software, Licenses/Membership Dues, Security, Office Supplies, Postage/Delivery, Printing, etc. Operating Costs Current FY ($) Current FY (%) Next FY ($) Next FY (%) Total Indirect Costs (%) Current FY ($) Current FY (%) Next FY ($) Next FY (%) Total Expenses Current FY Next FY Total Current FY Next FY SURPLUS/DEFICIT

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Project Budget Template Personnel Personnel (list staff positions/FTE) Total Project Budget Request to The AF Total Non-Personnel Operating Costs Total Project Budget Request to The AF Total Other Costs Subcontracts Total Project Budget Request to The AF Total Equipment Total Project Budget Request to The AF Total Fiscal Sponsor Fee Total Project Budget Request to The AF Total Other Source of Funding for the Project Other Source of Funding for the Project Total Project Budget Individual Contribution (Major Gifts) Foundation Grants Corporate Grants Government Grants Government Contracts Earned Income Development/Fundraising Revenues Total Sources of Funding for the Project In-Kind Support for the Project In-Kind Support for the Project (if applicable) Total Project Budget Total

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