FY 2023-24 ECIA Grant Application - 1-
2023-2024 ECIA COMMUNITY
GRANT PROGRAM APPLICATION
APPLICATION DEADLINE: Sunday, February 12, 2023, NO LATER THAN 11:59 p.m.
SECTION I – ORGANIZATION INFORMATION
Community-Based Organization Information (Applicant Information):
Fiscal Sponsor (Organization with 501(c)(3) tax status:
Name of Organization:
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Executive Director Name:
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Organization Address:
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Project Manager Name (primary contact for
the grant):
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Project Manager Title:
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Phone Number:
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Email Address:
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Program/Project Budget:
Program/Project Budget:
$ Click here to enter text.
Amount of Grant Funds requested:
$ Click here to enter text.
Organizational Budget:
$ Click here to enter text.
Fiscal-Sponsor Budget (If applicable):
$ Click here to enter text.
Program/Project:
Program/Project Title: Click here to enter text.
Program Project Summary (50-word limit): Click here to enter text.
% of Richmond Residents Served by Your Proposed Program/Project?: Click here to enter text.
Will Your Program or Project Serve Youth (through age 21)?: Click here to select “Yes” or “No”
Please select one (1) category that BEST describes the type of project or program that your organization plans to provide with the requested grant funds from the drop-down list:
CLICK HERE and Select the program category from the drop-down.
Name of Organization:
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Executive Director Name:
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Organization Address
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Project Manager Name (primary contact for
the grant):
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Project Manager Title:
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Email Address:
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Phone Number:
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FY 2023-24 ECIA Grant Application - 2-
2023-2024 ECIA COMMUNITY
GRANT PROGRAM APPLICATION
SECTION 2 – PROGRAM/PROJECT DESCRIPTION
a. Provide information about your organization (e.g., number of years in operation, description of services provided and the population served).
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b. Describe in detail the program or project your organization is proposing to implement with the grant funds. Clearly list the major components or aspects of your program or project.
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c. Provide a timeline for project implementation using the template below. Include specific tasks/activities that will be accomplished within each quarter.
Task/Activities Month
1st Term (July 1– December 31)
Click here to list, bullet, or number entries. Click here to list corresponding dates.
2nd Term (January 1– June 30)
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d. List the staff members responsible for the implementation of the program or project. Briefly describe the staff’s experience working on the proposed program/project and/or similar projects. Include résumés or provide descriptions of work experience with each copy of the application.
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e. If you plan to collaborate with other entities (i.e. , non-profits, governmental entities, private entities) to implement your program or project, please complete the table below.
Note: A letter of collaboration must be included as a part of your application ONLY IF your organization plans to partner with a government entity(ies) (e.g., city, state, county, school district, etc.).
Partner Specific Role:
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FY 2023-24 ECIA Grant Application - 3-
2023-2024 ECIA COMMUNITY
GRANT PROGRAM APPLICATION
SECTION 3 – PROJECT IMPACT AND GOALS
a. Describe the target population and geographic area that your organization plans to serve with the grant funds and w hat impact the proposed program or project will have on the target population.
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b. List the number of individuals that will be served as a result of your program or project.
Total Number of Individuals Served by
Proposed ECIA Funded Program or
Project
Total Number of Richmond Residents
Served by Proposed ECIA Funded
Program or Project
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c. List the major program or project goal(s) and how your organization will measure if you reach your desired goal. The goal should be measurable and data-driven. There should be at least one (1) expected outcome per major program or project component.
Major Program
Component(s)
Major Program
Outcome(s)
Indicator/
Measurement
Goal Evaluation
Method
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d. How will your organization assess or gauge the success of your pr ogram/project at its completion?
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e. How do you plan to sustain the program or project after the grant funds are expended? Click here to enter text.
SECTION 4 – FINANCIAL VIABILITY
a. Attach your organizational budget to each copy of the application . The organizational budget can be submitted in any format as long as it shows revenue and expenditures for your organization’s current operating year.
b. Complete the program budget table using the provided MS Word or MS Excel template to complete the table.
FY 2023-24 ECIA Grant Application - 4-
2023-2024 ECIA COMMUNITY
GRANT PROGRAM APPLICATION
ECIA GRANT APPLICATION SUBMISSION ACKNOWLEDGMENT
This page should be included in your application packet. It will not count toward your page limit.
By submitting this application and the supporting application materials, you agree that:
You are an Officer on the Board of Directors of the organization submitting the grant application
You have thoroughly read and understand the grant program guidelines and application questions and City of Richmond requirements (business license, insurance, and grant agreement)
All questions contained in the application have been answered and the following required documents are included as part of our application packet:
☐Completed application (all sections completed and questions answered, including resumes)
☐Organizational budget
☐Proof of 501(c)(3) status (Non-Profit Status Determination letter from the Internal Revenue Service)
☐Financial statements – most recent (current) audited financials or Internal Revenue Service Form 990 or 990-N. Reviewed or compiled annual financial statements are allowable for faith-based organizations.
☐List of Board of Directors and their affiliations
☐Letter describing and authorizing collaboration with a governmental entity(ies), if applicable
☐Signed agreement between the organization and the fiscal sponsor, if applicable
Your organization will obtain comprehensive background checks and/or fingerprinting of all employees and/or volunteers.
Volunteers that work directly with youth or such other vulnerable populations. (For applicable organizations requesting funds to support an existing or new youth program and/or program that works with other vulnerable populations.)
To the best of your knowledge, the information included as part of this application is true and accurate
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Click here to enter Organization Name.
Click here to enter a date from drop-down.
Click here to enter Name of Board Officer.
Click here to enter Title of Board Officer.
Signature – Officer of Board