Community Impact Grant Application | Fond du Lac Area Women's Fund

2025 Community Catalyst Grant Application

"*" indicates required fields

General Information

Today's Date*

Organization Name*

Legal Name

Address*

Street Address PO Box (if applicable) City State ZIP Code

Grant Contact Person*

First Last Title

(Note: Does not need to be same person signing the application.)

Phone*

Email*

Year Agency Established*

Mission Statement of Organization*

Please provide a general overview of your organization’s current services or programs.*

Brief description of the core services/programs your organization offers to its clients. (750-character maximum)

Total Number of Agency Clients Served Annually*

Number of Full-Time Equivalent Employees*

Number of Volunteers Directly Associated With Program/Project to be Funded*

Electronic Signature*

First Last Title

By submitting your name, you attest that the information contained in this application is complete and accurate. (Must be signed by supervisory staff member or Board of Directors’ president/chairperson of the organization’s governing body.)

Grant Details

Name of Project/Program to be Funded*

Amount Requested*

Purpose of Grant*

Choose one option that best describes your grant request’s purpose.

Area of Funding Priority*

Economic Self-Suffiency

Education

Health and Well-Being

Leadership Development

Safety, Dignity, and Freedom from Violence

(Please check all that apply.)

Program/Project Summary*

(50-word maximum)

Where is your program/project offered?*

Some programs/projects operate out of multiple locations. Please identify the primary location address of your program/project and any satellite locations, if applicable.

Does your program/project have any collaborating partners?*

Yes

Collaborating partners are any other agency working with you to provide services with your clients. Please be sure you’re noting your collaborations, as we view these as highly beneficial to the merits of your grant request.

If you answered "yes" to the previous question on collaborating partners, please list those partners here by name along with a very brief statement broadly explaining what the collaboration entails.

(If no collaborators, skip this question.)

Names of Current Board of Directors Serving Your Organization*

Focus/Funding Priorities

Please answer the following questions as they relate to your program/project’s focus on females and/or the FDLA Women’s Fund’s funding priorities. (Each question is limited to 750 to 1,000 characters.)

How is this program/project designed to primarily benefit Fond du Lac area women and/or girls?*

How does this program/project address the funding priority or priorities selected earlier in this application?*

What makes this program/project important? What sets this program/project or your organization apart from others in the area?

Goals, Objectives, and Outcomes

List no more than two program/project goals with accompanying outcomes and method of measuring success.

Goal 1*

Goal is defined as: The big picture. What do you want to get out of this project/program?

Goal 1 Intended Objective(s) and Outcome(s)*

Objective is defined as: The method you plan to use to achieve your goal. What steps will you take to meet the goal? Outcome is defined as: The measurable success that occurs. Be sure not only to identify the outcome, but also address what strategies/methods will be used to evaluate the success of your project/program? And who will be involved in evaluating your project/program success?

Goal 2

(Note: If your program/project does not have a another goal, skip this section.)

Goal 2 Intended Objective(s) and Outcome(s)

Target Population

Please answer the following questions to the best of your ability to estimate as to what population(s) your program/project will benefit annually.

What is the anticipated total number of participants to be served directly by your project/program annually?*

How many female-identifying idividuals will make up the annual program/project total served directly?*

How many male-identifying individuals will make up the annual program/project total served directly?*

How many female-identifying individuals will make up the annual program/project total served indirectly?*

These are not direct clients, but perhaps others associated to the client (family members, for example) who will have an indirect benefit by your work with the client. Please note: You will need a way to track this number on your evaluation tool(s).

Breakdown of female-identifying individuals served by age?*

Please use the following age breakdowns to describe how many women and/or girls you anticipate serving annually through your program/project: Number of Girls infant to 11 years old; Number of Girls 12 to 17 years; Number of Women 18 to 24 years; Number of Women 25 to 39 years; Number of Women 40 to 54 years; Number of Women 55 and older. If your program/project does not serve women/girls, please explain why and give age demographics for men/boys in the same category breakdowns described above.

Breakdown of female-identifying individuals served by race/ethnicity?*

Please use the following race/ethnicity categories to describe how many women and/or girls you anticipate serving annually through your program/project: American Indian/Native American; Asian or Pacific Islander; Black/African American; Hispanic/Latina; White/Caucasian; Multiracial; Unknown. If your program/project does not serve women/girls, please explain why and give race/ethnicity demographics for men/boys in the same category breakdowns described above.

Breakdown of female-identifying individuals served from a socioeconomic standpoint*

Please use 2024 U.S. Federal Poverty Guidelines to frame your answer. https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines If your program/project does not serve women/girls, please explain why and give socioeconomic demographics for men/boys in the same category breakdowns described above.

Required Attachments

Please upload the following attachments to complete your application.

Program/Project Budget (Outline how you plan to spend the funds you are asking for.)*

Max. file size: 50 MB.

Most Recent Past Fiscal Year Profit & Loss Statement*

Max. file size: 50 MB.

IRS 501(c)3 Letter of Determination*

Max. file size: 50 MB.

Final Review*

Yes, I’m ready to submit!

Note: Once you have submitted your application, no further changes can be made to your application.