1601 fifth avenue, suite 1900
seattle, wa 98101-3615
O 206.622.2294 F 206.622.7673
seattlefoundation.org
Resilience Fund Application
PUBLISH DATE:
May, 23 2017
INSTRUCTIONS:
Please complete the organizational information and the narrative section. Please then sign and
email completed application to [email protected] no later than June 26, 2017,
5pm. Questions? Please email [email protected].
Please Answer The Following Questions:
1. GENERAL INFORMATION
Name of organization:
Mailing address:
Physical Address (If different from mailing address):
Website:
Contact Person:
Title/Role:
2. NONPROFIT STATUS
501(c)3 IRS Determination
EIN (Tax ID):
Fiscally Sponsored
If organization is fiscally sponsored, please provide the following information:
Name of fiscal sponsor:
EIN (Tax ID):
Mailing address:
Website:
Contact Person:
Title/Role:
Email:
Phone:
3. GRANT REQUEST INFORMATION
Organization Annual Budget: $
Grant Request Amount: $
Geographic Area(s) to be Served Within King County:
1
1601 fifth avenue, suite 1900
seattle, wa 98101-3615
O 206.622.2294 F 206.622.7673
seattlefoundation.org
In one sentence, please describe what this grant is funding:
What communities are you planning to engage if funded? (Select all that apply)
Black or African American
Low Income
African
Refugee and Immigrant
American Indian and Alaska Native
Women
Asian
LGBTQ
Native Hawaiian and Other Pacific Islander
Seniors
Latino
Additional, please describe:
AUTHORIZED SIGNATURE OF APPLICANT / ORGANIZATION
To the best of my knowledge and belief, all information in this application is true and correct. The document has
been duly authorized by the governing body of the applicant who will comply with all contractual obligations if
the proposal is awarded funding.
Name and Title of Authorized Representative: _________________________________
Signature of Authorized Representative: ________________________________________
Date: _________________
(Application Cont’d)
2
4. NARRATIVE
Write a narrative response to sections A and B, answering each section relevantly and completely. Applications
will be rated only on the information requested and outlined for this application.
Total score = 100 points. The suggested length in responding to the narrative sections is a maximum of 3
pages.
A) PROJECT PURPOSE, ACTIVITIES AND OUTCOMES (40 Points)
1. Briefly describe your organization’s main focus of work.
2. Why are you applying for the Resilience Fund? Please explain specifically what unanticipated challenges or
amplified threats your organization is seeking to address. What outcome(s) do you plan to achieve as a
result of this funding?
3. Please describe why you think your organization is well-positioned to directly address the unanticipated
challenges or amplified threats your community is facing.
4. Please list any proposed activities and a timeframe.
B) COMMUNITY ENGAGEMENT STRATEGY (40 Points)
1. How does the organization’s leadership reflect the race, ethnicity, and challenges faced within the
community you represent?
2. If applicable, what other local partners will you be collaborating with if you receive this funding and what
communities/demographics do they represent?
3. Will any portion of these funds be re-granted to other organizations? If yes, please explain.
4. How will your organization evaluate progress and/or success if funded?
3
BUDGET (20 Points)
Complete the budget proposal sheet below. Costs entered should be for this project only, not the total
organization budget. Describe how these funds will be used and identify other fund sources that will be used to
complete the project if applicable. Please indicate the status of listed sources – e.g. awarded, proposed or
applied for.
Item
Staffing
Supplies
Food
Other Costs
Fiscal Sponsor Fee
(if applicable)
TOTAL EXPENSES
4
Resilience Funds
(up to $25,000)
Other Funds
Other Funds
Total Project