Please answer all questions completely. Agency & Program Name Program Grant Request (Enter dollar amount) A — PROGRAM DESCRIPTION AND ALIGNMENT A1 — What is the mission of your agency? About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. A2 — Please describe your program. What vital and basic needs in Hancock County are being addressed? What services and/or resources does your program provide to address these needs? About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. A3 — What role does United Way of Hancock County funding play in your programming? B — PROGRAM GOALS FOR 2026 B1 — What are the specific, measurable goals your program aims to accomplish in 2026? For each goal, outline the detailed action steps and anticipated outcomes, and explain how the requested funds will directly support these efforts. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. B2 — What is the long-term vision of your program beyond 2026? Describe the broader impact it seeks to make in the community and how it aligns with your organization’s mission and values. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. B3 — How has your agency’s program been impacted by community and external (i.e. local, state, or federal) changes within the past year? Please describe the impact and any adjustments your agency or program made in response. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. C — PROGRAM PERFORMANCE MEASURES AND METRICS C1 — Does this program address the root cause of community need or is it intended to meet emergency needs? Please explain. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. C2 — Is the impact on the individuals you serve short term, long term, or both? Please explain. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. C3 — How is your agency measurably improving and impacting lives throughout Hancock County? Feel free to provide examples of a testimony or success story that illustrates the impact of your work. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. D — STRATEGIC RELATIONSHIPS D1 — Please provide specific examples of how your program collaborates with other agencies or organizations in the community to create a greater collective impact. How do these partnerships enhance your program’s effectiveness in ways that would not be possible to do alone? About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. D2 — In what ways does your program cooperate with other organizations to align efforts and achieve shared goals? How does this cooperation improve efficiency, resource sharing, or service delivery compared to operating independently? About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. E — FINANCIAL DATA E1 — Please complete the attached financial data sheet for this specific program. Financial data spreadsheet. One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. F — FINANCIAL REVIEW (serves as a supplemental narrative to attached financial data) F1 — Provide the number of FTE’s (full time equivalents) that support this program. This should align with the salary dollars included in your program budget. Note: An employee who works half-time in the program would be 0.5 FTE. Number of FTE's included in payroll costs 2024 Actual 2025 budget 2025 forecast 2026 forecast F2 — Please explain significant changes, increases, and/or decreases that have occurred from the 2024 actuals to the 2026 budget. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. F3 — For organizations with multiple programs, please explain how revenues and expenses are tracked or assigned to each program. About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. F4 — Are all United Way funds requested being directed to serve only clients in Hancock County? (This is a yes or no question. If no, please explain.) About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. Lines and paragraphs break automatically. G — GRANT COMPLETION G1 — Please attach your most recent agency audit or financial review. One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. G2 — Attach your most recent board-approved financial statements (balance sheet and statement of activities/income statement). One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. G3 — Please attach Form 990, if applicable (Pages 1-12). One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. G4 — Please attach your agency's total budget. One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. G5 — Attach the Program Specific Questions One file only.200 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Leave this field blank
