2025 Community Impact & Innovation Grants Organization InformationOrganization Name(Required)EIN #(Required)PhoneAddress Line 1(Required)Address Line 2City(Required)State(Required)Zip Code(Required)CEO/Executive Director Name(Required)CEO/Executive Director Email(Required) Phone(Required)Name of person completing applicationEmail (if different from above) Total number of full-time employees(Required)Total number of clients served in the most recent program year (indicate if calendar year or fiscal year)(Required)Client Demographics (Optional)Age of clientsIncome range of clientsProposal DetailsAs briefly but completely as possible, please provide responses to the following. Please limit narrative responses to 500 words.MISSION STATEMENT(Required)Provide the mission statement of your organization.PROGRAM OR SERVICE DESCRIPTION(Required)Describe the program or service for which you are applying and how it contributes to meaningful change in your community. Describe the expected use and impact of the grant and how it will be demonstrated and/or measured.SOCIAL INNOVATION(Required)Explain any innovative approaches to program delivery or any differentiating factors that make your program or service unique. Please note any similar or duplicative programs in Chester County.TOTAL AMOUNT REQUESTED(Note: The CI Grant maximum is $50,000. Historically, the average grant amount has not exceeded $20,000)REQUEST JUSTIFICATION(Required)Provide a specific quantifiable justification for the amount requested. DO NOT include a statement of need but rather a calculation, budget reference, or other numerical evidence to support the dollar amount of your request.GEOGRAPHIC AREA(Required)Please indicate whether you serve all or part of Chester County. List your top 5 service area zip codes and client counts from each.TOP 3 FUNDERS(Required)Please list the 3 largest funding sources for your organization and indicate what percentage (%) of your overall organizational budget those funds represent. Include United Way if applicable.Projected OutcomesSelect the objective(s) below most closely aligned with the program/activity/services for which you are applying. Please note: performance reporting will require you to report against any outcomes selected here.Individuals receive assistance to stabilize condition Access to food assistance (food pantry, on-site meal service, meal delivery) Legal assistance Basic needs (MUST BE clearly defined, aligned with the needs of ALICE, unique and unduplicated in Chester County, and display a high level of measurable impact) Specify here:(Required)Individuals gain or maintain stable housing Temporary or transitional housing or shelter Permanent housing placement Housing and home-buyer support services Eviction prevention (landlord mediation, financial assistance) Home repairs / climatization that allow residents to maintain current living option Individuals gain access to health services Mental / behavioral health services (i.e. individual counseling, group therapy, pediatric treatment) Collaboration and Partnership(Required)Please share an example of a collaboration or partnership that strengthens or expands the outreach of any programs/activities/services described above.Required DocumentsOperating Budget(Required)Max. file size: 50 MB. Program Budget if applicableMax. file size: 50 MB. IRS 990Max. file size: 50 MB. Current Guidestar Profile CAPTCHAAcknowledgmentOrganizations submitting a grant proposal to CCUW acknowledge the following: • Submission of any grant proposal is not a guarantee of funding • All grant awards are at the sole discretion of the Community Impact Council and will be dependent in part on apparent or emerging community needs at the time of evaluation • No Community Impact & Innovation Grant will exceed $50,000 • CCUW retains the right to request information regarding the utilization of any grant awarded, and that all grant funds must be used for the terms as outlined in the submitted application unless a request to use the funds otherwise is submitted to and approved by the Council • All information presented as part of the application process is true and accurate to the best of the applicant’s ability
