Request for Applications: Small Grants

Transcription

1 Request for Applications: Small Grants Susan G. Komen North Central Alabama along with those who generously support us with their talent, time and resources is working to better the lives of those facing breast cancer in our community. We join breast cancer survivors and activists around the globe as part of the world s largest and most progressive grassroots network fighting breast cancer. Through events like the Komen North Central Alabama Race for the Cure, we have invested over $10 million in local breast health and breast cancer awareness projects in 38 counties. Seventy-five percent (75%) of net proceeds generated by the Komen North Central Alabama Affiliate stay in Alabama. The remaining income goes to the national Susan G. Komen Research Grants Program for energizing science to find the cures and provides funding for breast cancer research right here in Alabama! About Susan G. Komen Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything in her power to end breast cancer forever. In 1982, that promise became Susan G. Komen and launched the global breast cancer movement. Today, Komen is the world s largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure, we have invested more than $1.9 billion to fulfill our promise, becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world. For more information about Susan G. Komen, breast health or breast cancer, visit or call GO KOMEN. Funding Opportunities Komen North Central Alabama is currently offering grants up to $5,000 to support breast health education projects, and up to $1,999 to award conference and travel scholarships. Please see below for specific breakdowns based on category. Important Dates Small Grants Applications are accepted throughout the year. However, requests for support of travel scholarships, conferences, or other events must be received at least six weeks prior to the event. Eligibility Applicants must meet the following eligibility criteria to be considered for funding: All past and current Komen-funded grants or awards to applicant are up-to-date and in compliance with Komen requirements.

2 Small grant applicant has tax exempt status under the Internal Revenue Service code. Conference and travel scholarship applicant has completed W9 tax form. Applicant must be a non-profit organization or affiliated with a non-profit organization in the case of conference and travel scholarship applicants located in or providing services to one or more of the following locations: o Bibb, Blount, Calhoun, Chambers, Cherokee, Chilton, Clay, Cleburne, Colbert, Coosa, Cullman, DeKalb, Etowah, Fayette, Franklin, Green, Hale, Jackson, Jefferson, Lamar, Lauderdale, Lawrence, Limestone, Madison, Marion, Marshall, Morgan, Perry, Pickens, Randolph, Shelby, St. Clair, Sumter, Talladega, Tallapoosa, Tuscaloosa, Walker, and Winston. Project or conference/travel must be specific to breast health and/or breast cancer. Funding requests should not be for projects that provide direct services such as screening, diagnostics, or treatment and would normally go through the yearly peer-reviewed Komen Community Grant process. If applicant, or any of its key employees, directors, officers or agents is convicted of fraud or a crime involving any other financial or administrative impropriety, applicant is not eligible to apply for a grant during this current cycle and will not be eligible to apply for a new grant until the later of 12 months after the conviction or until applicant can demonstrate that appropriate remedial measures have been taken to ensure that any criminal misconduct does not recur. Allowable Expenses Funds may be used for the following types of program expenses: Educational materials Meeting Costs Supplies Travel Other direct program expenses Equipment for educational purposes Funds may not be used for the following purposes: Screening, diagnostics or treatment Medical equipment Medical or scientific research Scholarships or fellowships In-direct costs Construction or renovation of facilities Political campaigns or lobbying Endowments Debt Reduction Salaries Consultants Sub-Contracts

3 Travel Scholarships Purpose: To assist grantees, health care professionals and advocates to attend, participate in and/or present at meetings, conferences or symposia that would increase the community knowledge of breast cancer and facilitate the exchange of ideas and communication between the scientific and lay public. Amount: Up to $999 for domestic travel and $1999 for international travel. Travel scholarship recipients must submit original receipts and a final report in order to be reimbursed. If being reimbursed presents a hardship on the recipient, the scholarships may be issued as a travel advance. If unused funds remain from the travel advance, the grant recipient must return the monies within 30 days of event completion. Applications must be received 4 weeks prior to the event Applicants must reside in the Affiliate service area Repeat applications (those submitted two years in a row) will not be considered Applicant must submit a copy of the conference agenda or program Recognition requirements: Recipients must recognize Susan G. Komen North Central Alabama on all presentation materials (i.e. scientific poster or PowerPoint slide) with the appropriate logo. The exact requirements are to be outlined in the grant contract. Application Instructions Conference and Travel Grant Abstract The abstract should be limited to 1200 characters. The abstract should provide a brief description of the proposal including the following: 1) the purpose of your travel; 2) a description of key activities; 3) name, date, and location of conference and 4) the likely impact of the program to your career/life goals. Program Description The narrative description must contain the following information: A description of the conference or activity How attending this conference will further Komen s mission Conference agenda Goals and Objectives for Conference Attendance/Travel Budget Provide an estimated budget for your travel. All receipts must be turned in to the Komen office after the conference as a budget justification. Select either: o Domestic travel: up to $999 o International travel: up to $1999 W9 All applicants must complete a W9 tax form prior to receiving payment.

4 Conference/Event Grants Purpose: To partner with other organizations to support local scientific or educational conferences, with an emphasis on those that enhance the interaction between the advocate, healthcare and scientific communities. The content must focus on breast cancer or breast cancer must make up a significant part of the conference Amount: Up to $5,000. Applications must be submitted 6 weeks prior to event Applicants must submit an agenda or program for the event including information about the attending speakers and/or presenters Applicants must submit an in-depth budget and budget justification Recognition requirements: Conference organizers must provide complimentary registration for at least two (2) Affiliate representatives and an Affiliate display area when appropriate. In addition, the Komen North Central Alabama must be recognized on all materials with the appropriate logo. The exact requirements are to be outlined in the grant contract. Application Instructions Conference/Event Grant Abstract The abstract should be limited to 1200 characters. The abstract should provide a brief description of the proposal including the following: 1) the purpose of the program; 2) a description of key activities; 3) a summary of evaluation methods; and 4) the likely impact of the program. Organization Summary Complete the organization summary page. It should include a brief description of the following: 1) organization s history and if your program is part of a larger organization; 2) an explanation of the mission of the larger entity and your relationship to it; 3) the mission of the organization; 4) the current programs and accomplishments; 5) explanation of how your organization seeks to be diverse and inclusive; 6) number of paid full time staff, volunteers and total annual organization budget. Program Description The narrative description below must contain the following information: A description of the program or activity How this grant will further Komen s mission For conferences only- anticipated number of participants, description of target participants, description of conference format including specific topics to be covered and speakers, if known.

5 Goals and Objectives for the Conference/Event Budget Provide a detailed total program budget. All funding for this program, including other grants and general funds should be included in the budget. For each line item in the budget, provide a brief description of how the funds will be used and why they are programmatically necessary. List all other committed and pending sources of support for the program. For each budget section, please request funds in whole dollars only. Attachments 1. Information regarding Key Personnel For key personnel that are currently employed by the applicant, provide a resume or curriculum vitae. For new or vacant positions, provide job descriptions (Two page limit per individual). 2. Proof of Non-Profit Status To document your federal tax-exempt status, attach your determination letter from the Internal Revenue Service. Evidence of state or local exemption will not be accepted. Please do not attach your Federal tax return. 3. Certificate of Insurance outlining insurance coverage secured by the applicant, whether in general or specifically for the proposed conference/event 3. Letters of support, collaboration, MOUs, etc. demonstrating your partnerships. 4. Evaluation forms, surveys, logic model, etc. related to demonstrating the effectiveness of your program as defined in your work plan. Educational Materials and Messages Susan G. Komen is a source of information about breast cancer for people all over the world. To reduce confusion and reinforce learning, we require that grantees provide educational messages and materials that are consistent with those promoted by Komen, including promoting the message of breast self- awareness and knowing your risks for breast cancer. Please visit the following website before completing your application and be sure that your organization can agree to promote these messages: Susan G. Komen does not promote self breast exams, but rather breast self - awareness. Komen grantees are eligible to receive preferred pricing for Komen educational materials. Komen materials should be used and displayed whenever possible. To view our educational materials, visit Submission Requirements Komen North Central Alabama uses an entirely online grant management system, which is available at: User guides are available at and upon request.

6 Hard copies will NOT be accepted. If the applicant does not have access to a computer, please contact the Komen office to schedule a time for technology support. If you have questions relating to completing and submitting the grant application, please contact Deanna Fowler at or dfowler@komenncalabama.org. Please allow adequate time before deadline for response to any inquiry. The grant application process is competitive, whether or not an organization has received a grant in the past. Funding in subsequent years is never guaranteed.