
“Stopping Domestic Violence and Gun Violence. Guiding our Youth and Saving Families for Generations to come!”
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Mental Health Empath

What to expect
Grant Eligibility/ Requirements REVIEW BEFORE BOOKING!
Section One: Overview
Please provide an overview of your proposal, including:
- Brief description of the proposal- Purpose and key anticipated outcomes- Individuals or communities served- Amount of funding requested- Overview of how funds will be spent- Timeline
Section Two: Organization information
Please provide your organization mission statement.
Tell us about the history of your organization.
Tell us about your current programs and activities.
Please describe a few top accomplishments of your organization within the last three years.
Please provide your IRS EIN number.
Please list your Board of Directors and include short bios.
Please list key staff involved with this project and upload/attach their resumes.
Please upload/attach the following financial documents:
- Cash flow statement- Audited financial statements- Current operating budget
Section Three: Proposal details
Please describe the problem or need which you seek to solve.
Please describe the purpose and objectives of your proposal.
Please provide details regarding the design and strategy of your proposal.
Please provide an overview of your proposed timeline.
Please provide your proposed budget.
Please list any partners in this proposal, and the partner’s role and your relationship with them.
Please identify the anticipated leadership of the proposal and upload/atttach their resume(s).
Please describe your plan for sustainability of the project or initiative after the grant award has been exhausted.
Section Four: Evaluation information
Please describe the desired measurable outcomes and their anticipated timeline.
Please describe how you intend to measure and report on the effectiveness of the proposal.
Section Five: Supplementary information
Please enter a third-party reference.
Please upload/attach your annual report.
Please include any supplementary documents which you feel will be essential to the review committee.
Section Six: Contact information
Name.
Email address.
Website.
Phone number.
Address.
Section Seven: Optional Demographic Survey
Race (select all that apply)
â–¡ American Indian or Alaska Native (e.g. Navajo Nation, Nez Perce Tribe, Mayan, Aztec, Nome Eskimo Community, etc.)â–¡ Asian (e.g. Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc.)â–¡ Black, African American (e.g. African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, etc.)â–¡ Hispanic or Latinx (e.g. Mexican or Mexican-American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc.)â–¡ Middle Eastern or North African (e.g. Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, etc.)â–¡ White (e.g. German, Irish, English, Italian, Polish, French, etc.)â–¡ Other race, ethnicity or originâ–¡ Prefer to self-describe
â–¡ Prefer not to say
Gender
â–¡ Femaleâ–¡ Maleâ–¡ Non-binary/third genderâ–¡ Prefer to self-describe
â–¡ Prefer not to say
Sexuality
â–¡ Heterosexual or straightâ–¡ Gay or lesbianâ–¡ Bisexualâ–¡ Asexualâ–¡ Prefer to self-describe
â–¡ Prefer not to say
Do you identify as disabled or non-disabled?
â–¡ Disabledâ–¡ Non-disabled