- Project Title, County served, Start/End dates of project, project budget and amount requesting.
- Project Summary (100 word max) – briefly describe your project and its significance in the Pioneer Valley. Include the number of people to be served and the geography targeted.
- Information on your type of request; i.e. Arts/Education, etc. (select from drop-down list).
- Population served (select from drop-down list).
- Age group (select from drop-down list).
- Ethnicity (select from drop-down list).
- Gender (select from drop-down list).
- Primary collaborators. Be prepared to include letters of collaboration.
- Project Narrative (100 words max) – explain how this request fits with your organization’s mission.
- Need for Project (200 word max).
- Project Plan (300 word max).
- Personnel (200 word max) – qualifications and roles of personnel associated with the project’s implementation.
- Program Outcomes (300 word max) – detail the projected outcomes.
- Impact (300 word max) – describe the criteria for success, the desired results of your program and the benefit to the community.
- Evaluation (300 word max.) – explain how results will be measured and evaluated.
- Funding & Sustainability (200 word max) – detail other funding sources and how you will sustain the project in the future.
- If full funding is not received, how will the project be completed? (200 word max).
- The Bigger Picture (200 word max) – What distinguishes the proposed project from other similar projects being offered in the Pioneer Valley?
Required financial reports (these reports will need to be uploaded to the application):
- Operating Budget for the current fiscal year;
- Prior year financials:
- Income & Expense Statement for organizations with a gross revenue of less than $200,000;
- Reviewed Financial Statements for organizations with a gross revenue of $200,000 to $500,000;
- Most recent Audit for organizations with a gross revenue of over $500,000.
- For organizations with a gross revenue and support of $200,000 or greater: If there is a gap year between the Operating Budget and the Reviewed Financial Statements or Audit, please attach an Income and Expense statement for the gap year;
- For organizations with a gross revenue of less than $200,000, please attach a Balance Sheet.
Additional required information:
- Structure of your organization
- Structure of your board
- Documentation on the 501(c)3 eligibility of the organization
- A 501(c)3 determination letter will need to be uploaded to the application