Fillable SpecialInterestsFundingApplication AtaGlanceSummary Amount Granted Requested (City of Coppell)

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SpecialInterestsFundingApplication AtaGlanceSummary Amount Granted Requested (City of Coppell)

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PleasecontactCayceLay,BudgetManager,atclay@coppelltx.govor(972)304‐3690withquestions.
SpecialInterestsFundingApplication
AtaGlanceSummary
Date:
OrganizationName:
PersonCompletingInformation:
Amount
Requested
(FY20/21):
Amount
Granted
(FY19/20):
Amount
Requested
(FY19/20):
NarrativeofRequest/ScopeofServiceProvided:
ExplainReason(s)forIncrease/DecreaseinFundingRequest:
TotalNumberofIndividualsReceivingService:
NumberofCoppellResidentsReceivingService:
PercentageofCoppellResidentsvs.TotalNumberReceivingService:
TotalOperatingBudget:
PriorYear: CurrentYear: Proposed:
DollarValueofServicesProvidedtoCo
ppellResidents:
PercentageofOperatingBudgetFromCoppell:
OverheadPercentage:
NumberofPersonsinOrganization: Employees: Volunteers:
501.c.3/Non‐ProfitNumber:
PleasecontactCayceLay,BudgetManager,atclay@coppelltx.govor(972)304‐3690withquestions.
SpecialInterestsFundingApplication(Page2)
Thefollowingthreequestionsmayrequireadditionalspaceordocumentation.Pleasesubmitthatwith
theapplicationinastandardizedformat.
Pleaseprovidetheorganization’smissionstatementandlisttheservices,programs,and/oraidthat
directlybenefitsthecitizensofCoppell.
Describethelong‐termfinancialplanfortheorganizationasitrelatestooutsidefunding;specifically
outlineanyfundraising,sustainabilityplans,orpartnerships,includingCoppell.
Provideananticipatedtimeframeforthefundingrequeststoincrease,decrease,orceaseasitrelates
totheorganization’slong‐termfinancialgoals.
PartnerCities
/Agencies Amount
Percentageof
FundsReceived
Percentageof
Svcs.Rendered
Tothe
bestofmyknowledge,theinformationsubmittedaccuratelyreflectsthefinancialstatusofthe
requestingorganization.
Signed:
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SpecialInterestsFundingApplication AtaGlanceSummary Amount Granted Requested (City of Coppell)

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Completed 2 August 2020

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