Grant Application 2025-2028 - Part 2

Current Information
Target Population
Funding
Goals and More
Signature
Complete

Agency

Program

Listing the following email addresses will allow for copies of the submission of this form to be emailed to you once submitted.

Chief Executive Officer's Email

Is the Local Contact Person's email the same as Chief Executive Officer's email?

Yes

Local Contact Person's Email

Is the Program Director's email the same as Local Contact Person's and/or the Chief Executive Officer's email?

Yes

Program Director's Email

Do you want to send a copy of the submission of this form to another email address other than the one(s) listed above?

Yes

Additional Email

Select your Impact Area for this Program.

Health

Education

Financial Stability

Basic Needs

How does your program align with the Bold Goal of the Health Initiative?

Health Boal Goal: Improve the mental health of Chippewa Valley residents.

Max: 750 words

How does your program align with the Bold Goal of the Education Initiative?

Education Bold Goal: Children in the Chippewa Valley will enter school ready to succeed.

Max: 750 words

How does your program align with the Bold Goal of the Financial Stability Initiative?

Financial Stability Bold Goal: Chippewa Valley residents will achieve self-sufficiency through employment training and personal money management skills.

Max: 750 words

How does your program align with the Bold Goal of the Basic Needs Initiative?

Basic Needs Bold Goal: Chippewa Valley residents will have access to food, shelter and medical services in their time of need.

Max: 750 words

Describe your organization’s qualifications (e.g., staff’s knowledge, competency, experience and licensure) and any historical data that demonstrate previous accomplishments (e.g., program capacity, longevity, awards, community recognition and success rate). If this is a new program, describe any documented success related to your other programs.

Max: 600 words

Describe how your program will be staffed and how the staff and volunteers will be prepared, trained and managed.

Max: 600 words