Program Support Grant for Organizations

The Program Support Grant’s online application follows the outline below. The outline acts as a guide for writing the grant and articulates grant specific attachments. When submitting the hard copy of the grant packet, collate the grant packet in the order of the grant outline. (*) Required Fields. NOTE: For the application to be eligible for consideration, all question items must have a response, even if the response is N/A.

1. ORGANIZATTION PROFILE:

Organization’s Name:*

Address:*

Do you have a physical (non PO Box) address in the City of Alexandria? Yes No

Has your address changed in the last 12 months? Yes No

City:* State:* Zip:*

Contact Person this Grant:* Title:

Telephone (day):* Telephone (evening):

Organization’s Website:*Email Address:* (A copy of this application will be sent to this email address)

Fiscal Year Start and End Dates: (must be with the grant period July 1, 2017-June 30, 2018)*

Start: (pull down calendar)End: (pull down calendar)

What is the organization’s mission, vision and history? Please include the top three recent accomplishments.* (300 word limit)

Have you received a grant from the City of Alexandria in the past 3 years?1

Yes No

If yes, were you able to meet your funding obligations?

If you were not able to meet your obligation, what Fiscal Year was this and what was the reason? (200 words)

VA Tax Exempt Number:*

Date on which IRS Issued Letter of Determination for Non-Profit Status:* _____________________Required: Attach the organization’s letter of determination for the non-profit status as a 501c 3 organization.

I declare that I am authorized to act for the above applicant. I submit this grant application to the City of Alexandria and confirm that the information contained herein is accurate to the best of my knowledge and belief. *

2. FUNDING REQUESTProgram Title: (15 words) * Please review online the list of ineligible activities supported by this grant.

Program Grant Request Amount (Up to $7,500 and shall not exceed 50% of program’s total budget):*

Program Budget (Total Cash Income Budgeted during the grant period):*

What Percentage of the Program Budget is this Request? (not to exceed 50%)*

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Upload IRS Letter

3. ARTISTIC CONTENT

3.A. PROGRAM ACTIVITIES AND GOALS

A.1. Provide a brief description of your program of your program request – what will the funding be used for? (200 words)

A.2. Describe your organization’s programs and activities for this grant period. Be specific and reference the Program calendar. * (400 words)

A.3. Describe the programs goals and outcomes you are committed to achieving with this program grant during the grant period through this program grant. Present your goals in SMART format: Specific, Measurable, Attainable, Relevant, Timely. * See examples https://www.projectsmart.co.uk/smart-goals.php.(400 words )

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Upload Calendar Attachment

A.4. If this is a new program, provide past examples of executing activities similar to this request. If this is an ongoing program, provide examples of how you have been successful in implementing the program so far.* (400 words)

A.5. Describe how the organization’s program activities and goals during the grant period align with the goals of the City’s Strategic Plan. Please reference the City Manager’s Performance Plan and use specific examples of the organization’s past and future programming that has/will help further the City’s Strategic Plan and goals. * https://www.alexandriava.gov/uploadedFiles/performance/CityManagersPerformancePlanFY14-16.pdf (300 words)

A.6. What makes this program different from other programs being offered by other groups in the City of Alexandria? * (300 words)

A.7. Identify key artistic personnel who will lead and implement the program related to this grant request. Discuss how their background supports the artistic excellence, innovation, and sound financial management of your program. This should reference the Key Personnel Attachment. (300 words)

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B. ARTISTIC CONTENT: WORK SAMPLES

B.1. Describe how and why the arts and/or arts education content of the uploaded work sample(s) best represent(s) your organization. Describe how this work delivers excellence and achieves about stated goals* (300 words)

4. IMPACT AND ENGAGEMENT

A. How will the program’s activities during the grant period provide opportunities for citizens of the City of Alexandria to engage with the arts in a meaningful way? Discuss educational and outreach activities associated with artistic programming. Provide evidence of how your organization positively impacts the citizens of Alexandria. * (400 words)

B. Describe how your program’s activities promote inclusion, diversity, equity and access. Demonstrate the organization’s intentional efforts and commitment to ensuring parity in audiences, participants, staff and board. * (400 words)

C. Expected number of individuals served by this program grant request during the grant period: *_____________

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Upload work samples

D. Define your target audience. How will the Program’s activities be marketed to the specific target audiences and to reach new/diverse audiences? * (300 words)

E. Describe the methods used to track participation in the Program’s activities and document the impact on individuals. If this is an ongoing program describe changes implemented to ensure the Program’s continued growth as a result of your evaluation processes. * (300 words)

F. If partnerships are involved in any of the program activities or efforts discussed above, note them with relevant details such as financial, resource sharing and/or in-kind. If not, explain why. (300 words)

5. BUDGET AND MANAGEMENT

5.A. BUDGET:

A.1. Cash Income for organization’s most previous completed Fiscal Year: *___________________

A.2. Cash Expenses for organization’s most previous completed Fiscal Year: *_________________

A.3.Total Program Budget for this grant period:*_______________________. (Cash Income and Expenses must match)

Upload the completed Program Budget Form here: File size must be less than 2MB) Use Budget Worksheet

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Upload

A.4. Please provide an overall narrative explanation of the program budget. Describe how the amounts allocated to the budget line items advance the organization’s programs and/or mission, goals. * (400 words) Note any significant shifts in income and/or expenses from year to year. Explain any income or expenses listed in the “other category on the budget worksheet that are greater than $1,000. Indicate any additional information you think the grants panel should know about the organization’s financial position and/or Fiscal Year budget.

5.B. MANAGEMENT

B.1. Expected number of full-time employees paid by this grant or in part. Include full-time equivalent of part-time employees: *_____________________________________________

B.2. Expected number of full-time employees paid by this grant or in part that reside in the City of Alexandria. Include full-time equivalent of part-time employees: *______________________________

B.3. Expected number of volunteer hours supporting this program during the grant period: *___________________

B.4. Describe the background of key personnel that aid in making this program a success, that qualify them for their positions, highlighting their education, accomplishments, and their success in the managing arts organizations. This should reference Key Personnel Attachment. * (300 words)

B.5. If your organization does not receive full funding of your request, describe how your organization will be able to fulfill the obligations of the grant i.e., what changes will need to be made to the operations, programs, services or event? * (300 word limit)

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REQUIRED ATTACHMENTS: *

Resume(s) with addresses of key personnel (Artistic/Managing/Executive Directors, Arts Educators, etc.) * (Save as one PDF, then upload, File size must be less than 2MB )

List of Artists and Program Managers involved with the program, roles for the program and Bios* (Save as one PDF, then upload, File size must be less than 2MB)

Work Samples and File Identification List *

Supporting Materials 1: Three to five internally produced materials such as brochures, marketing materials, etc. (Save as one PDF, then upload, File size must be less than 2MB)

Supporting Materials 2: Externally provided support materials such as press/reviews, letters of support media feeds, etc. (Save as one PDF, then upload, File size must be less than 2MB)

OPTIONAL MATERIALS:

In-kind contributions Services: (Save as one PDF, then upload, File size must be less than 2MB)

In-kind Volunteer Hours: (Save as one PDF, then upload, File size must be less than 2MB)

Marketing and Fundraising Plans: (Save as one PDF, then upload, File size must be less than 2MB)

Strategic Plan: (Save as one PDF, then upload, File size must be less than 2MB)

TEMPLATES:

Calendar Template In-Kind Support Contribution of Services In-Kind Support Volunteers Program Budget Form

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Upload

Upload

Upload

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Upload

TEMPLATES:

PROGRAM CALENDAR OF EVENTS: Please upload a program calendar of events in this format. (File size must be less than 2MB)

Date Event Location Anticipated Attendance Ticket Price

Total Anticipated Attendance:________________________________(Insert number for anticipated attendance)

Cost Per Person Impacted by this application:________________________(Formula to be placed here anticipated attendance / requested amount)

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IN-KIND SUPPORT- SERVICES1. Estimate the value of the in-kind contributions the organization expects to receive in Fiscal Year

2018. If exact figures are not available, refer to in-kind donations from previous fiscal years to support your estimates. Upload this data in an itemized table with donor information and the estimated cash value—to the nearest dollar—of the support.

In-kind contributions are non-cash donations such as materials (e.g., office supplies from a local retailer), facilities (e.g., rent), and services (e.g., printing costs from a local printer). Provide this information in a table format include goods or services and their monetary value received from arts organizations (e.g. arts agencies, arts councils, museums, etc.); corporations or private businesses; individuals (exclude volunteer hours; local government (city and/or county); state government; other sources.

(this can be an upload chart)

In-Kind Support - Company Contributor. Please provide a list of contributors for the In-Kind support to your organization

Company/Contributor*In-Kind Support Item/Service

Estimated Value of In-KindWhole Numbers (ex. 120)

How is Value Determined

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Total

Total Value of In-Kind:

IN-KIND SUPPORT- VOLUNTEER HOURS2.3. 2. Upload a table that outlines the organizations expected volunteer support in Fiscal Year 2018. The

table should include the following columns: volunteer role(s), number of volunteers in this role, and expected hours served. If exact figures are not available, please use volunteer data from previous fiscal years to support your estimates.

When considering volunteers roles, be sure to include all of the following: professional volunteers (e.g. , executive/program staff, volunteer coordinator, board members, pro-bono consultants); artistic volunteers (e.g. , artists, choreographers, designers); clerical volunteers (e.g. , administrative support); service volunteers (e.g. , ticket takers, docents, gift shop volunteers); seasonal and other miscellaneous volunteers

In-Kind Support - Volunteers

Role of Volunteers

Number of Volunteers

Serving This Role

Whole Numbers (ex.

120)

Estimated Value of

Volunteer HoursWhole

Numbers (ex. 120)

How is Value Determined

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Totals

Total Number of Volunteers Serving This Role::

Total Value of Volunteer Hours::

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BUDGET Worksheet

A. Budget: INCOME:

B. Program Budget: INCOME: Earned Income:

GRANT YEARJuly 1, 2017- June 30, 2018

A. Events/Admissions

B. Contract Services/Fees

C. Membership Income

D. Publications, T-shirts, CDs, other products

E. OtherPrivate Support:

GRANT YEARJuly 1, 2017- June 30, 2018

F. Corporate

G. Foundation

H. Individuals

I. OtherGovernment Support:

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GRANT YEARJuly 1, 2017- June 30, 2018

J. Federal Government Grants and Support

K. Regional

L. State Government Grants andM. Local Government Grants and Support

(include ACA Grant)N. Interest Income

O. Income from your endowment

P. Cash on HandQ. All other Revenue and Support (not

classified above)TOTAL CASH INCOME:

C. Program Budget: EXPENSE:

Personnel and Payroll Expenses (excluding payment to artists):GRANT YEAR

July 1, 2017- June 30, 2018A. Total administrative project payroll

(including full-time and part-time staff)B. Total payroll taxes and fringe benefits

(including FICA)C. Contractors (i.e., full-time and part-time

contract staff)D. Other personnel expenses (not classified

above)

Payment to Artists (e.g., performances, commission, etc.):GRANT YEAR

July 1, 2017- June 30, 2018E. Payments to LOCAL artists (i.e., live within

the City of Alexandria)F. Payroll taxes and fringe benefits (including

FICA) for local artistsG. Payments to NON-LOCAL artists (i.e., live

outside the City of Alexandria)H. Payroll taxes and fringe benefits (including

FICA) for NON-LOCAL artists

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Overheads and Programmatic Expenses:GRANT YEAR

July 1, 2017- June 30, 2018I. Advertising, marketing and other

promotional costsJ. Contractor services (part-time or seasonal,

including accounting and legal)K. InsuranceL. Office machinery (excluding capital

expenditures) and equipment rentalM. Postage

N. Programming and production expenses

O. Publication, videos, CDs

P. Supplies and materialsQ. Communication costs (e.g., phone, fax,

internet, communication technology)R. Travel Costs

S. Other (not classified above)

Facility Expenses:GRANT YEAR

July 1, 2017- June 30, 2018T. Rental and/or lease costs (Administrative)

U. Rental and/or lease cost (Artistic)

V. Mortgage costs

W. Property Taxes

X. Utilities (e.g., electric, water, and refuse)

Y. Other facility costs (not classified above)

Please provide your organization’s total capital expenditure asset acquisition for your most recent fiscal year:

GRANT YEARJuly 1, 2017- June 30, 2018

AA. Equipment purchases and improvements (e.g., computer equipment and upgrades, instruments, sound systems, lighting systems, easels)

BB. Art purchases (i.e., additions to a collection)

CC. Real estate purchases16

DD. Construction of new facilitiesEE.Renovation and/or improvement of existing

facilitiesFF. Other Capital Expenditures (not classified

above)

TOTAL CASH EXPENSES

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