Program Application Portion

2018 APPLICATION DEADLINE: MAY 7th, 5:00pm.

Each agency must fill out the Program Application Portion. Agencies may apply for multiple programs. Multiple programs may be in different impact areas or within the same impact area. A separate Program Application MUST be completed for each grant program request.

PLEASE START WITH THE AGENCY GENERAL APPLICATION.

Agency Name*
Email Address Of Main Contact*
Program Name Applying For Grant*
United Way Of Lee County Funding Request*
What Counties Does The Program Serve?*
Focus Area*
- Health
- Education
- Financial Stability
- Youth & Community Enrichment
Please select the focus area that the program fits.
Program Description*
Matching Grants*

If the program receives a grant requiring a match, what percentage? If you do not have a match requirement enter "0".
Is this a new program?*
- Yes
- No
Please Attach Your Demographics For The Program.*
Accepted file types: jpg, jpeg, pdf, doc, docx, xls, xlsx, Max. file size: 256 MB.
Information Required: # Served By Town, # Served Other Counties, Age Group If Available.
Files must be less than 20 MB.
Allowed file types: jpg jpeg pdf doc docx xls xlsx.
Program Budget*
Accepted file types: jpg, jpeg, pdf, doc, docx, xls, xlsx, Max. file size: 256 MB.
Please insert the program budget for the most recent fiscal year ended, if applicable.
Files must be less than 20 MB.
Allowed file types: jpg jpeg pdf doc docx xls xlsx.
Please Explain How You Will Use UW Funds.*
How Do You Reach Lee County Residents So They Are Aware Of The Program And Services?*
List Names Of Agencies You Collaborate With To Help Run The Program.*
What Barriers Or Threats Do You Face In Regards To The Program?*
Social Or Financial Factors That Could Affect The Program And/Or Agency In The Future?*
How do you know if your program is successful? What are the benefits or changes for individuals during or after participating in program activities. How well is the program achieving the desired outcome?*
Provide a success story from this program that can be shared publicly. If needed, you may change names to protect the identity of children and those in sensitive situations.*
If possible, provide a photo that can be used publicly, including social media. If the picture includes identifiable people a photo release is also required. A photo will result in additional promotion of your program and will be beneficial to both United Way and your organization.
Drop files here or

Accepted file types: jpg, png, eps, gif, svg, pdf, doc, docx, xls, xlsx, Max. file size: 256 MB.
• Upload Photo (not required) • Upload Photo Release (not required) Allowed file types: jpg,png,eps,gif,svg,pdf,doc,docx,xls,xlsx.
Name Of Person Preparing Form*
Date
MM slash DD slash YYYY
CAPTCHA

* A link to a pdf of your entries will be emailed to you after submission. But you can use the print screen button below to preview your entries.

2018 APPLICATION DEADLINE: MAY 7th, 5:00pm.

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