Community Technology $5000 Minigrant Program

Wikipedia defines “thinking outside the box” as a cliché or catchphrase used to refer to looking at a problem from a new perspective without preconceptions, sometimes called the process of lateral thought. The Alliance in cooperation with the Community Connect Foundation is looking for just that! We’re hoping that communities all across West Virginia will take the time to ask; how can technology make this a better project? The primary focus of this program will be to foster technology based projects that address solutions to community problems in the geographical service area of the Alliance of West Virginia Champion Communities, Inc. For further information regarding eligible service areas please visit http://www.alliancewv.org. We want creative thinkers; people not afraid to take a chance by proposing innovative ideas and implementing them into the community. So, if you believe your current or ongoing project can benefit from implementing new or innovative technology, then please take the time to read the guidelines/application in detail and must be postmarked by July 3, 2007.

In order to qualify for this minigrant, the fiscal agent must be a 501 c (3) organization or governmental agency that will be responsible for payments to the grantee. What if you are not? Then you will have to work in partnership with a local governmental agency or a non-profit charitable organization (see attached list for examples). All participating agencies, organizations and/or groups must have a minimum of five members. Three of the five members must attend a mandatory training session at one of three locations. Applicants should design their projects to encourage a very short timetable. Projects should be able to commence upon completion of required training and to conclude in four months or less. Should the applicant require more than four (4) months to complete their project, an additional sixty (60) days may be approved, but ONLY IF EXTENUATING CIRCUMSTANCES EXIST. Anything beyond four months must be requested in writing, and the extension approved BEFORE the original project end date.

We are requesting that you complete this Grant Application Form so that we may give consideration to your request for funding. Please understand that as part of its obligation to exercise due diligence with respect to any grant, and to comply with other legal requirements, the Foundation may seek information about your organization and people involved with your organization from a variety of sources. Additional documentation may be required of your people or organization if funded. The selection of successful grant applicants is the sole discretion of the Community Connect Foundation. The total project costs cannot exceed the minigrant maximum of $5000.00 unless the additional costs have been secured from other funding sources.

Let’s get started. Here is what we need from you.

Pre-application meetings: May 29, 2007 - WVDHHR Office 1400 Virginia Street, Oak Hill, WV. 25901 May 31, 2007 - WV Rehabilitation Center , Barron Drive, Institute, WV. 25112 June 5, 2007 - Gassaway Community Center, 416 Elk Street, Gassaway, WV. 26624

All sections of the application must be completed in order to qualify for grant.

Mail one original of the entire grant proposal to:

Community Technology Minigrant,

PO Box 747

Alum Creek, WV25003-0747.

or send one electronic version of this application to be emailed to: mfortin@natcor.com

Please note: A minimum of three representatives out of a five or more member group must attend required

training sessions and the Celebration Event.

Community Technology Minigrant Application

Name of Organization or Group:

Mailing Address:

Website:

Project leader:

Phone Number

Fax

Email

Name of Project:

One Sentence Summary of Project:

Requested Amount:

Contact name and title for Project:

Daytime Phone Number

Fax

Email

Cell Phone (Optional)

Evening Phone Number (Optional)

Check applicable box: q 1. 501 c (3) organization	Name of Organization, Governmental Agency, Other, or Volunteer Group
q 2. Governmental Agency
q 3. Other
q 4. Volunteers
If you checked box number 3 or 4 you must provide information on your qualifying fiscal agent
501 c (3) or Governmental Agency Fiscal Agent:	Name
Mailing Address:
Contact name:
Phone Number
Fax
Email

Name of Project members: 3 of these members must attend mandatory training	Affiliation and contact information:
1.
2.
3.
4.
5.
6.

Add additional names as needed.

2. Organizational History: Brief narrative of the organization/group seeking funding. Include: mission and purpose, how long it has been in existence, services provided, and geographical area served. Not to exceed two pages.

(Insert here)

3. Project Description: Describe the project for which funding is being sought. Include: the problem being addressed, strategies and activities that will address the problem, objectives of the project, and target population to be served. Indicate the number of people/households/communities or other unit to be reached by this project and the geographical area served by the project. Explain how you intend to promote this project in your community. Not to exceed two pages.

(Insert here)

4. Outcomes: List the actual impacts/benefits/changes anticipated as a result of this project, and how

you will measure progress in reaching these outcomes.

Outcomes	Performance measures
1.
2.
3.
4.
5.
6.

Add outcomes as needed.

5. Implementation Plan: List the phases of project implementation and related activities (e.g. research

and planning, pilot testing, evaluation). Include the start and end dates for each phase.

Phase/Activity	Start Date	End Date
1.
2.
3.
4.
5.
6.

Add phase/activities as needed.

6. Budget: Provide a project budget that lists: the functional line item expenditure; each source of revenue and the amount requested from the Foundation. Please note, personnel expenses are not allowable. Computer purchase requests will be viewed on an individual case basis but are not encouraged.

a) Project Budget

The total project budget: $________________________

Requested amount from the Community Connect Foundation: $__________________

Funding sources, including in-kind, and amounts for current project budget:

Source	Amount
1.
2.
3.
4.
5.
6.

Add space as needed

b) Project Expenses

Expense	Amount
1.
2.
3.
4.
5.
6.

Add space as needed

This grant will be disbursed to the fiscal agent as follows:

70% may be requested upon completion of the training session with participants identified in accordance with the grant application.

20% may be requested upon the submission of the required midterm report that indicates a majority of expenditures have been paid.

10% upon completion of project unless alternative disbursement is requested and approved by the Community Connect Foundation.

7. Copy organization’s IRS 501 c (3) non-profit determination letter.

Note: 501 c (3) determination letter is not required for governmental entities. If applicable, submit confirmation letter of fiscal agent. The fiscal agent shall make its accounting records available for inspection by the Alliance of West Virginia Champion Communities, Inc. during regular business hours for a period beginning with the date of the grant and ending four years after the last grant funds have been expended.

Each application may not exceed 10 pages, font size 12 with 1-inch margins (excluding required forms and attachments).

If your application is approved the following information will be requested.

1. Current financials: fiscal agency budget; project budget; and last fiscal year Form 990 or a copy of the most recent Audited Financial Statement from the fiscal agent.

2. Current Board of Directors list, including names and occupation, note officers.

3. If applicable, include the following: letters from financial, collaborative or programmatic partners in the proposed project such as signed contracts with other agencies contributing funding, volunteer, and/or in-kind contributions documentation of completion of certification process, as listed on the budget pages.

4. Your organization’s or the fiscal agents (which ever is applicable) most recent annual report.

*******Applications must be mailed or emailed and postmarked by July 3, 2007

The Community Technology minigrant program is broken down into seven categories. You may choose more than one category. If more than one category is selected prioritize using numbers 1,2,3.

_____ Business and Industry activities

_____ Education related activities

_____ Healthcare activities

_____ Community-based activities

_____ Government activities

_____ Tourism activities

_____ Agriculture activities

Has your organization or group ever received funding for technology in the past? If so, at what amount and what was the intended purpose of the funds?

(Insert here)

Reporting Requirements include a Midpoint report and Final report.

Midpoint Report must include the following:

A written progress report narrative outlining outcomes and implementation statuses. Provide a three column financial report that represents the project budget expenses (this should be taken from your grant proposal), the actual expenses, and the difference between the two.

Final Report must include the following:

A narrative outlining final outcomes. In addition, please respond to the following questions:

Has the grant made a difference in the quality of services or effectiveness? In so in what ways? If not what obstacles limited your work?

What impact did the grant have on the population served?

During the course of the project, did anything happen that was different from what you expected?

How will the lessons you learned change your future thinking, performance or services?

Limit your total narrative grant report to no more than two pages.

Provide a three column financial report that represents the project budget expenses (this should be taken from your grant proposal), the actual expenses, and the difference between the two.

Tell us a how this project addressed the problem identified by your organization or group and how the technology was implemented to resolve the problem in a news release format. (This will actually be sent to local, regional, and state media). Limited to two or three paragraphs.

Training sessions (9:00 am – 3:00pm).

Oak Hill August 4, 2007

Institute August 18, 2007

Gassaway August 25, 2007

Celebration Event

Charleston April 5, 2008

It is mandatory that a minimum of three representatives from your organization or group attend one of the three available training sessions and the Celebration event. . One person from each project must do a three to five minute presentation with photographs on the project. This presentation must include information as provided in the final report.

Signature of application contact Date

______________________________________________ ______________

Signature of project contact (if different from above) Date

______________________________________________ ______________

Evaluation Criteria

1. Narrative (40 points)

(a) How effectively the application describes the following aspects of the project: the history of this project, the need and the targeted population demographic area served.

(b) The Project Design – How the requested funds increase the technological aspect of the project.

(c) Outcomes and Performance Measures – Are the desired outcomes and performance measures realistic and can be accomplished within the time frame identified in your project.

(d) How effectively the project is promoted in the community being served.

2. Impact Evaluation (40 points)

(a) Does the project address the problem as defined?

(b) Does the project have a direct impact on the use of technology into the future?

(c) Does the project involve bringing the community together?

1. Is there a potential to stimulate your local economy?

2. Is there interest from local business or neighborhood groups to assist with the project?

(d) After completion of the project, how will it be sustained and what plans are in place for

sustaining it?

(e) Does the project have long-term implications for the targeted population or demographic area

served?

3. Project Innovation ( 20 points)

(a) Is the project an innovative way of resolving the problem as identified?

(b) Can this project be replicated?

(c) Does this project build community partnerships?

Proposed Timeline

Approval of Application by Advisory Committee: April 27, 2007

Pre-Application Workshops May 29, 2007

May 31, 2007

June 5, 2007

Application Deadline July 3, 2007

Review Period July 13, 2007

Grant Approval by Advisory Committee of CCF July 17, 2007

Grant Award Approval by the Alliance July 18, 2007

Award and Non-Award Winners Notified July 23, 2007

Training Sessions August 4, 2007

August 18, 2007

August 25, 2007

Project Completion Deadline January 31, 2008 or

March 31, 2008

Celebration Event April 5, 2008