Fillable APPLICATION DUE DATE JANUARY 8, 2021 (City of Newport News)

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APPLICATION DUE DATE JANUARY 8, 2021 (City of Newport News)

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APPLICATION DUE DATE – JANUARY 8, 2021
PURPOSE
The City of Newport News recognizes that not-for-profit organizations fill an important role in improving the quality of life
for our community. To encourage not-for-profit organizations to provide services to residents of Newport News, the City
has an established system to award monetary grants to qualified organizations.
These grants are intended to:
• Provide funding to not-for-profit agencies serving the City of Newport News whose services are easily
accessible to Newport News residents and whose service costs can be documented.
• Provide incentive funding to develop new services or capital improvements to meet specific needs of Newport
News residents, and to complement services provided by City departments.
These grants are incentives to foster new services or expand existing services in the City. A goal of the process is to
encourage community/local/citizen support for programs so that City grant funds can be replaced with funding from other
sources. This will allow the City grant funds to be directed toward new programs in the future.
GRANT REQUEST INSTRUCTIONS
The Community Support Agency Grant request consists of four parts:
1. General Information
2. Financial Information
3. Specific program information for which funding is requested
4. Performance Measurement and Outcome Measurement information
Applications are due no later than January 8, 2021. Please submit your completed
application and all required attachments via e-mail to budget@nnva.gov
Please contact the Department of Budget and Evaluation at 926-8733 with any questions.
1
DIR
ECTIONS FOR COMPLETING APPLICATION
The application information provided should be specific to the particular program for which community support grant
funding is being requested. Single service agencies may provide information which incorporates the entire agency
operation. Multi-program agencies should provide information on only the specific services or programs to be considered
for the Community Support Agency Grant program.
PART ONE: GENERAL INFORMATION
Please provide requested agency information. If funding request is for a single service or program, check the "Single
Service Program" line and provide the name of the service or program. If the funding request is for multiple programs,
check the "Overall Agency Support" line.
ATTACHMENTS:
• New grant applicants must provide the five (5) attachments requested in this section (see Page 4).
• Current year (FY 2021) grant recipients must provide the five (5) attachments requested in this section if a
current version is not already on file. Please note if the current version is already on file.
PART
TWO: FINANCIAL INFORMATION
This section is designed to capture financial information for the specific program for which funding is requested. Part Two
is divided into two worksheets. The first worksheet addresses the organization’s Revenues and Expenditures and the
second worksheet addresses the organization’s balance sheet.
The f
ollowing information may be helpful to clarify certain items. The City of Newport News operates on a fiscal year basis
from July 1 through the following June 30. However, the financial information requested in this section is for the agency's
accounting year regardless if it is different from the City's.
Note: If funding is being requested for a single program, only Revenues and Expenditures for that program should be
shown. If funding is being requested for overall agency support, the total agency budget for Revenues and Expenditures
should be shown.
REVENUE AND EXPENSES
• Prior Year Actual [Column 1]: Actual Revenues and Expenditures for most recently completed fiscal year.
• Current Year Budget [Column 2]: The program's budget for the current fiscal year.
• Next Year Request [Column 3]: Projected Revenues and Expenses for the next fiscal year.
Revenues: The amount of income estimated by the agency from all sources, including grant funds, being
requested from the City of Newport News in this application. Expenditures: The amount of expenses projected
to operate the program or agency.
• Percentage Difference [Column 4]: Percentage Change from Current Year Budget [Column 2] to Next Year
Request [Column 3].
• Reason for Variance [Column 5]: Please provide reason for any percentage increases or decreases greater
than 5% in Column 4.
BALANCE SHEET
• As of 6/30/2020 [Column 1]: Statement of Financial position as of 6/30/2020
• As of 6/30/2020 [Column 2]: Statement of Financial Position as of 6/30/2019
2
Community Support Agency Grant Program
FY 2022 Application
PART THREE: PROGRAM INFORMATION
This section contains a series of questions designed to capture the impact that the agency will generate with or without
funding from the City of Newport News.
PART FOUR: PERFORMANCE MEASUREMENT
The City of Newport News has incorporated a performance measurement framework into all its budgetary functions to
emphasize and to help obtain community outcomes. Outcome Measures indicate the change in the conditions of well-
being for resident and nonresident children, adults, and families due to the programs or services provided. Outcome
Measures focus on why services are performed (the intended results of the program/service/project), as opposed to how
services are performed (number of visitors/participants). Applicants are asked to describe how the organization measures
their performance and what impact the activity or program for which funding is being requested has on their “customers”.
Specific Outcome Measures should be identified under the following categories. These are suggested areas; the Outcome
Measures are not limited to these categories only:
• Economic Drivers: Funding the requested grant will result in job growth, attract revenue (an example, tourism
dollars), and stabilize property values.
• Educational Assets: Funding the requested grant will result in improved children’s success in school or
improved adult educational attainment.
• Health and Welfare Supports: Funding the requested
grant will result in an increase in individual self-
sufficiency, increase in employment, or improved health outcomes.
• Civic Catalysts: Funding the requested grant will result in greater community safety or create a welcoming
sense of place that brings people together.
• Cultural Legacies: Funding the requested grant will preserve the heritage of the City’s unique natural and
cultural resources for future generations to enjoy.
Organizations that receive funding will be asked to provide the City with semi-annual reports on performance measures.
Reporting forms will be provided by the City and will be available on the Budget and Evaluation website:
http://www.nnva.gov/213/Community-Support-Agency-Grant-Program
All applications will be reviewed using the following criteria:
• Record of financial sustainability
• Ability to leverage other funding
• Uniqueness of programs/services provided and complement to City programs/services
• Clear objectives and outcome measures
• Impact on the community clearly described
• Other City funding received
3
The agency’s account year is *(check one):
January 1 through December 31 (calendar year)
July 1 through June 30 (same as City’s fiscal year)
Other Year (Please describe):
Be sure that your request for funds falls within the City's fiscal year (July 1 through June 30). If the agency receives an
award, funding will be provided in accordance with the Community Support Agency Grant Guidelines and Procedures.
ATTAC
HMENTS: Include the following as attachments to the application, if the current version is not already on file
(Provide last revision date of the items on file):
• Cop
y of IRS 501(c)(3) Determination Letter
• Current approved by-laws, mission statement, charter
• The most recent Audited Financial Statements prepared by an independent Certified Public Accountant or the
most recent IRS filing (990 or 990EZ form)
• Most recent list of Board of Directors
Date:
PART ONE: GENERAL INFORMATION
Agency Name:
Add
ress:
Agency Website:
Grant Contact
Name and Title :
Grant Contact
Phone and E-Mail:
Total Current Year
Agency Budget:
Total amount of
requested
funding:
Funding is requested
for:
single program and/or overall agency support
If single program –
please provide name
and brief description of
program.
4
PART TWO: FINANCIAL INFORMATION
Please complete the financial worksheets which are in Excel format and can be found on the Budget and Evaluation
website: http://www.nnva.gov/213/Community-Support-Agency-Grant-Program
5
1. ORGANIZATION DESCRIPTION AND MISSION: Describe the programs and services provided by the organization
and how it benefits Newport News residents.
2. ORGANIZATION OBJECTIVES: Describe the organization's objectives. What does the organization strive to
accomplish?
3. COMMUNITY SUPPORT FUNDING: Describe the funding request in detail. Describe how funding from the
Community Support Agency Grant program would further the objectives of the organization. How would
these funds be used? What would this funding permit the organization to do? How would these funds be
used if the request is partially funded? If a current grant recipient and are requesting increased funding for
next fiscal year, please explain the need for additional funds.
6
4. SUSTAINABILITY: Describe how programs/services will be sustained if Community Support Agency Grant funding
is no longer available. Are plans already in progress to meet the need if/when City support ends or must be
reduced?
4a. What is the impact (quantitatively) on the citizens of Newport News if this funding request is denied?
4b. Could the organization implement or increases fees, or find alternative resources to make up for the denied
funding?
7
5. OTHER FUNDING REQUESTS: From what other sources has funding been requested? These should also be listed
in the Revenues Worksheet in Part Two of the application.
Funding Source
Amount Requested
Amount
Approved
Reason Funding Not Approved
(if applicable)
6. PARTNERSHIPS: If the organization receives or refers clients to City Departments please note this below.
RECEIVES clients from:
Average Annual
number of clients:
REFERS clients to:
Average annual
number of clients:
6a. Describe any partnerships with City Departments or other local agencies that further agency objectives
8
7. SIMILAR SERVICES: What other agencies (local, regional, state, federal, city, other) have programs or provide
services that either closely parallel or duplicate services provided by the organization?
PART FOUR: PERFORMANCE MEASUREMENT
8. PERFORMANCE MEASUREMENT: Describe how effectiveness of programs is measured by the organization. How
does the organization measure its impact? What outcomes does the organization strive to attain? Please see the
examples of Outcome Measures on Page 3.
Please fill out this table with your Performance Measurement information. Include at least one Outcome Measure.
These are some definitions and examples of performance measures that may be helpful.
Workload Measure (How much did we do?)
• Number of customers served
• Number of activities held
Efficiency/Effectiveness Measure: (How well did we do?)
• Customer satisfaction
• Cost per customer
• Percent of actions that are timely and correct
Outco
me Measure: (Is anyone better off?)
• Change in behavior, circumstances, results due to services
9
Performance Measure
Type
Prior Year
Actual
Current
Year Goal
Next Year
Goal
Prior Year
Actual
Current
Year Goal
Next Year
Goal
Total number of people served
Number of Newport News residents served
10
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APPLICATION DUE DATE JANUARY 8, 2021 (City of Newport News)

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Completed 24 January 2021

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