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Outside Agency Funding Request

Thank you for your interest in requesting funding from the Brighton Legacy Foundation. Please refer to our Funding Policy before applying. Also, please use our new online application to submit your request. Note: if you have any issues getting your application to submit properly, please check the instructions carefully to make sure you have followed all of the guidelines, including ensuring that files do not exceed the listed acceptable size!

IMPORTANT! YOUR APPLICATION IS NOT COMPLETE UNTIL YOU RECEIVE A MESSAGE IMMEDIATELY BELOW THE SUBMIT BUTTON THAT CONFIRMS YOUR APPLICATION HAS BEEN SENT SUCCESSFULLY.

SECTION A: AGENCY AND CONTACT INFO
This request for funding must be submitted by a Board Official, or the chief staff person of the agency.

Project Title (required)

Agency Name (required)

Contact Person (person submitting request) (required)

Contact Title (required)

Contact Email (required)

Contact Phone (required)

Address (required)

City (required)

Zip Code (required)

Amount Requested (required)
$

Nonprofit Status (required) YesNoIn process
Copy of non-profit status provided? (maximum file size 2MB, in PDF, JPG, Doc, or Docx format only please)
YesNo

Project Duration (if applicable)?
Begin End

SECTION B: PROJECT CONCEPT/DESIGN

1. What is the overall problem your project/organization will address? (required)

2. Define in concise terms what specific services will be provided by this project/organization and what the anticipated outcome will be? (required)

3. List the objectives of this project/organization in concise terms. (required)

4. What problem(s) do you anticipate in implementing your program's goals and objective, if any? (required--if none anticipated, enter "none")

SECTION C: SERVICE INFORMATION

1. Define the population and geographic area targeted for service through this project/organization. (required)

2. How many people are in need of these services? (required)

3. How many people are presently being served by your organization? (required)

4. How many people from Brighton will be served during its operation? (required)

5. Percentage of clients who are Brighton residents? (required)
%

6. Please identify how many Brighton residents fall into each of the following groups: (required--if zero, please enter 0)
Youth Adults
Seniors Family
Disabled Other

7. What is the source of information used to verify the need for the services your organization is providing? (required)

8. Define the management plan for the project/organization. (required--specifically who will be responsible/accountable for the administration of the project)

9. Are there currently any other community agencies providing like services in the target population? If so, who? If not, why not? (required)

10. Define any cooperative activities among similar agencies that will participate in this project/organization? (required)

11. Specify how this project/organization will diminish or eliminate duplication of services. (required)

12. Explain the differences between your agency and others that provide similar services. (required)

13. Please explain your plan to assure economic self-sufficiency of the program/project after City funding ceases. (required)

14. Has your organization made provisions for including a Brighton citizen on your Board of Directors? If no, then why not? (required)

15. Please include here any additional information that is pertinent to this grant request.

FOOD PANTRY REQUESTS ONLY: PLEASE INCLUDE THE FOLLOWING REQUIRED INFORMATION:

16. Do you have or do you plan to have a garden for summer produce?

17. Do you receive consistent funding from your church’s budget and/or individual congregation members?

18. Do you work with your clients to get them on government supported food assistance programs if they qualify?

SECTION C: AGENCY/ORGANIZATIONAL FINANCIAL INFORMATION

1. Amount requested from Brighton Legacy Foundation? (required)
$

2. Will this amount provide full financial support? (required)
YesNoDon't Know

3. What is the percentage of Agency's total revenues received from Brighton? (required)
%

4. Please list all other funding sources or contributions anticipated, including in-kind sources of support such as donated materials and volunteer hours:
A. Value/Quantity Received YesNoIn ProcessIn-kind
B. Value/Quantity Received YesNoIn ProcessIn-kind
C. Value/Quantity Received YesNoIn ProcessIn-kind
D. Value/Quantity Received YesNoIn ProcessIn-kind
E. Value/Quantity Received YesNoIn ProcessIn-kind
F. Value/Quantity Received YesNoIn ProcessIn-kind
G. Value/Quantity Received YesNoIn ProcessIn-kind
H. Value/Quantity Received YesNoIn ProcessIn-kind
I. Value/Quantity Received YesNoIn ProcessIn-kind

SECTION D: REQUIRED DOCUMENTS
NOTE: file size for each document may not exceed 2MB, and FILES MUST BE ONE OF THE FOLLOWING FORMATS ONLY: PDF, DOC, DOCX, JPG.

1. Organizational Budget: Present year, past year, and proposed, in balance sheet format, identifying revenues and line item expenditures. Identify other revenue sources on a separate page.

2. Listing of Board of Directors and Key officers, or active volunteers.

3. Most recent financial statement and/or audit report as listed below. (If your agency/project has presented their grant request during a Foundation board interview, and received funding from Brighton Legacy Foundation in the past two years, you may skip this section. In person interview and financial information is required every three years.)
Revenues/Expenses Required Documentation
Less than $25,000 Unaudited Statement
$25,000 - $50,000 Accountant's Compilation
$50,000 - $150,000 Accountant's Review
Greater than $150,000 Financial Audit
Unaudited agencies may have special provisions regarding funding imposed by The Brighton Legacy Foundation.

ACCEPTANCE OF TERMS:
By checking this box I affirm that I am a legal representative of the requesting agency authorized to request funding and that all of the information I have submitted is true and accurate to the best of my knowledge. I understand that if my organization is selected as a funding recipient, the award amount and project information will be public knowledge. Furthermore, I acknowledge that I may be photographed or video recorded as part of the award process, and that my likeness may be used for promotional activities related to Brighton Legacy Foundation's marketing efforts, and I agree to hold Brighton Legacy Foundation and the City of Brighton free from all liability related to the use of my likeness.

Type this CASE SENSITIVE code into the field below.
captcha

***************************** READ THIS SECTION THOROUGHLY BEFORE SUBMITTING *****************************
Please make sure that all fields are filled in correctly, that you have attached all of the required supporting documentation, and that you have checked the Acceptance of Terms box above. When you are sure, hit the submit button below.

NOTE: It takes a minute or so to transmit your application depending upon the size of your file attachments and your internet connection speed. During this time, you will see a rotating processing indicator to the right of the Submit button. If nothing appears to be happening OR you are redirected to the top of the application form, recheck that you have completed all of the steps. YOUR APPLICATION IS NOT COMPLETE UNTIL YOU RECEIVE A MESSAGE IMMEDIATELY BELOW THE SUBMIT BUTTON THAT CONFIRMS YOUR APPLICATION HAS BEEN SENT SUCCESSFULLY.
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