Strong Start Neighborhood Pilot
FUNDING APPLICATION
November 2014-October 31, 2015
COVER PAGE
Only programs that can support the desired outcomes of the Strong Start initiative within the identified neighborhood
will be considered for funding. Applicants will select measures from the UWWC identified list for reporting.
Information provided below will be used to communicate with the agency throughout the review process and grant
period if funding is awarded. It is incumbent upon the agency to inform UWWC of any changes in contact information as
soon as possible.
PROGRAM INFORMATION
Program Name:
Program Director:
Email and Telephone:
Program Address:
City:
ZIP Code:
Total Funding Request (November 2014-October 31, 2015)
Program Type:  Caregiver/Child Group
 Parent Education/Skill Building/Family Engagement
If awarded funding, when can you start programming? (Month/Year):
ORGANIZATION INFORMATION
Organization Name:
Leadership:
Email and Telephone:
Address:
City:
Telephone:
E-Mail:
Website:
Application Contact Person/Title:
Email and Telephone:
ZIP Code:
APPLICATION INSTRUCTIONS
All application components and questions are required. Provide the answer to each question in the form provided
below, using caution not to distort tables or formatting. The questions are listed in bold to help ensure applicant
answers can be easily identified. Font should be a minimum size 10 and the completed application – excluding
requested attachments (Financials, Required Documentation, etc.) should be no more than 12 pages long.
Do not attach any documents that are not requested and do not put completed application in a folder or binder,
only staple or paper clip. Please review the Request For Proposal announcement for complete submission
instructions.
PROGRAM SUMMARY
Provide a brief (300 word maximum) description of the program. Include the organization and program name,
population served, and key program elements. This information may be used in public communications including
being posted on the United Way of Western Connecticut’s website.
PROGRAM DESCRIPTION AND ALIGNMENT WITH STRONG START
1.) Select the program type (Caregiver-Child Groups or Parent Education/Skill Building/Family Engagement) and
identify the strategy it supports in the list below. Only programs that can support the desired outcomes of
Strong Start and serve parents/caregivers with children prenatal to age 5 within the identified neighborhood
will be considered for funding.
____
Parent/Caregiver-Child Groups
Groups that increase language, literacy, and numeracy skills for young children.
Measures: # children exhibiting developmentally appropriate language, literacy, or numeracy skills
# children screened and/or referred for early intervention services
# children who secure needed early intervention services
Groups that develop the social-emotional and self- regulation skills of young children.
Measures: # children exhibiting developmentally appropriate social- emotional skills
# children screened and/or referred for early intervention services
# children who secure needed early intervention services
Groups that respond to the needs and concerns of caregivers by providing relevant subject
expertise.
Measures: # parent/caregiver requested topics covered in groups AND appropriate measures
reflecting increased understanding of topic.
# parents/caregivers screened and connected to benefits
# of parents/caregivers referred to appropriate programs (ESL, VITA, etc.)
____
Parent/Caregiver Education, Skill Building, or Family Engagement
Programs that build parenting skills and/or develop safe, nurturing home environments for young
children.
Measures: # children and adults benefitting from parent support programs
# children screened and/or referred for early intervention services
# children who secure needed early intervention services
Programs that help parents understand, access, and navigate service systems (social services,
education, and government.)
Measures: # of resident Kindergarten registrations by end of May
# parents/caregivers screened and connected to benefits
# of parents/caregivers referred to appropriate programs (ESL, VITA, etc.)
Further demonstrate program alignment with the program type/strategy selection identified above when
answering the questions below. Use of evidence or research based programs is generally preferred.
2.) Describe the program, core purpose, and services provided.
3.) What research or evidence supports the use of this program?
POPULATION SERVED & PROGRAM ACCESSIBILITY
4.) Provide a profile of the target population including demographics, socio-economics, and/or needs. Describe
your organization’s and program’s experience serving this population, including length of time providing the
service.
5.) How will you identify participants from the identified neighborhood for the program? Describe how this
funding will increase the number of neighborhood residents/children that can be provided the services beyond
what is already available.
6.) Briefly describe how many individuals the program can serve with the requested funding and the primary
outcomes participants will achieve. (You will be asked for more specific measures later.)
7.) Describe the program’s capacity level, and if applicable, how clients on a wait list are managed.
8.) Describe any criteria used to determine whether or not someone is eligible to receive services.
9.) Provide information on any fees that will be charged, how they are used, and how/if the program will be
accessible to those who can’t afford to pay.
10.) How do/will you assess program participant needs? Discuss use of participant feedback and satisfaction in
program improvements.
11.) Describe when and where program services will take place. What efforts are made to ensure the program is
accessible to the target population (hours, childcare, meal, languages, transportation, etc.)?
WRAP AROUND SUPPORTS & PARTNERSHIPS
Questions in this section are designed to give the review team a better understanding of wrap around supports and
strategic partnerships that will support the proposed neighborhood program. Please only include information on
services that are relevant to this program funding request.
12.) What additional services do you provide to participants through your program or organization?
13.) Describe any specific partnerships you have with other agencies to meet your participants’ needs.
14.) Is your program different from other programs offering similar services in the community?
PROGRAM STAFFING
15.) Identify key program staffing for the neighborhood work and complete table. If staff will be
hired/confirmed following a funding announcement, please list positions as “vacant” and provide information
about senior staff responsible for hiring and program implementation. You may add a brief narrative statement
to explain staffing below the table.
Job Title
Education and
Credentials
Qualifications
Responsibilities
Years of
Service
PERFORMANCE MEASUREMENT
16.) Please complete the chart below using one or more of the UWWC identified measures listed previously with
strategies (Program Description and Alignment with Strong Start Section.) You must select at least one UWWC
measure, but may add up to two agency/program measures for reporting.
a. Identify one to three UWWC identified performance measures you will use for the program.
b. Provide information on your program’s performance on selected measures last year (if applicable) and
projected goal for the grant period.
Measure:
Last Year:
Goal for Grant Period:
Total
Number of
Participants
Served by
Program
Number of
Participants
Who
Received
Specific
Service
Number of
Participants
Who Secured
Outcome
%
Measure:
Total
Number of
Participants
Served by
Program
Number of
Participants
Who
Received
Specific
Service
Number of
Participants
Who Secured
Outcome
%
Total
Number of
Participants
Served by
Program
Number of
Participants
Who
Received
Specific
Service
Number of
Participants
Who Secured
Outcome
%
Last Year:
Goal for Grant Period:
Measure:
Last Year:
Goal for Grant Period:
PROGRAM BUDGET
17.) Provide (or attach) a program budget.
18.) Please answer the questions below related to your program budget:
a. Provide context to the neighborhood portion of the work if it is part of a larger program budget.
b. Discuss how UWWC funding will be used in the identified neighborhood.
c. Discuss how UWWC funds are used to secure or complement other sources of funding.
APPENDICES
Please review instructions to ensure all required materials and appendices are completed.