2023 Grant Application

2023 Grant Application

Community Health Options awards grants and makes donations as part of our Community Benefit Expenditure (CBE), administered by the Maine Community Foundation. We will award several grants ranging from $2,500 to $5,000 during our 2023 grant cycle, opening March 10, 2023.

The CBE supports nonprofit, grass root community-based programs in Maine that promote physical and emotional health.

To apply, please provide your information in the spaces provided below. Your application must be completed in one online session because once you begin, you may not save a draft and continue later. We suggest typing your answers in a document and cutting and pasting them in the application when you are ready.

You will be required to upload an electronic copy of your IRS determination indicating qualified 501c(3) or fiscal sponsor tax-exempt status during this session.

Please be aware, grants may be awarded for your full project amount or as partial funding. If you already received a CBE grant in 2022, you must wait 12 months from your grant award date to apply for another CBE grant. The 2023 grant cycle application deadline is 5:00 p.m., Friday, April 7, 2023. Grant recipients will be contacted in early May 2023.

1. What is the name of your organization?

2. What is the full mailing address of your organization?

3. What year was your organization founded?

4. Name of person submitting this application:

5. Job title of person submitting this application:

6. Phone number for contacting you:

7. Email address for contacting you:

8. What Maine counties does your organization serve?

Please select "All counties" or the specific counties that apply in the list below.

Select or enter value

9. How many people do you employ?

10. Does your organization serve the needs of those 64 and under?

11. 501c(3) or Fiscal Sponsor Tax Exempt Status*

You will be prompted to attached the IRS determination indicating qualified 501c(3) or fiscal sponsor tax exempt status at the end of this application.

12. Please provide a concise description of your organization’s mission and how you support activities that support and improve physical and emotional health. (100 words or less)

13. What % of your budget is Maine-based?

14. Describe how this program/initiative will help address health concerns in Maine?

15. Describe the central objective for the effort you propose. (30 words or less)

16. Estimate the number of Maine people your project will serve. (20 words or less)

17. What is the long-term vision of the project, and how does it align with our mission to support nonprofit, grass root community-based programs in Maine that promote physical and emotional health?

18. Provide a description of the project you propose, including a brief history; or if this is a new project, describe how it was initiated. You may include any additional, relevant information, including one or two links. (200 words or less)

19. Please describe your goals to sustain the program/project over time and what does sustainability mean to you?

20. Does your organization have a budget under a $1 million? (Those with a fiscal sponsorship arrangement are welcome to apply.)

If you have a fiscal sponsorship agreement, please attach it at the end of the application.

21. Please provide a clear and achievable budget for your proposed project/program (not your overall operating budget)? Please describe how this funding will be leveraged. (100 words or less)

22. Please list 4-6 key activities you are planning. (100 words or less)

23. Please list a timeline with key dates and deliverables for your project over the next 12 months. (100 words or less)

24. Is there a plan to sustain the outcome of the general operations, and what does sustainability mean to you?

25. Describe how you will measure the impact of your proposed project. (100 words or less)

Note: All projects must be fully operational within 12 months of the grant award. A grant report measuring the progress and impact of your project is required and will be due 12 months from the date of the award.

26. Can you accept and work with partial funding?

27. Would your organization consider placing the Health Options logo on promotional materials for your program/initiative?

Attach the IRS determination indicating qualified 501c(3) or fiscal sponsor tax exempt status.

If your organization has a fiscal sponsorship arrangement, please also attach the fiscal sponsorship agreement here.

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