2024 Agency Grant Application

Yes No

THE FOLLOWING INFORMATION IS REQUIRED FOR YOUR AGENCY TO BE CONSIDERED FOR FUNDING BY THE KEWANEE AREA UNITED WAY. PLEASE COMPLETE EACH SECTION OF THIS APPLICATION AS IT IS SPECIFIED BELOW. CONTACT THE KEWANEE AREA UNITED WAY WITH ANY QUESTIONS REGARDING COMPLETION OF THIS APPLICATION.

Section I: Who We Are

  1. Yes No
  2. Yes No

Section II: What We Do

Section III: Who is Served

Section IV: How is success measured?

Section V: Agency Partnership

Section VI: : Funding Request and information

  1. Yes No (If yes, please complete the chart below.)
Grantor Requested amount Award Amount if approved Year(s) for which grant is applicable Comments (if no comments please enter N/A)
  1. Yes No (If Yes, please complete the chart below.)
Grantor Year(s) applicable Amount of Matching Grant
  1. Yes No
  2. Yes No

Section VII: Agency Fundraising

  1. List major agency fundraisers that are scheduled for the upcoming year. Please notify KAUW if these are scheduled during the Annual Campaign period.
Agency Fundraisers Location Date

Note: KAUW will post Fundraisers to KAUW’s website and Facebook platforms if possible.

Section VIII: Other needs/Issues

  1. Yes No

Section IX: Additional Data (Complete the tables below)

ABCD (Area Board for Child Development)
Sections Question 1 Answer Question 2 Answer Question 3 Answer Question 4 Answer
Agency Number of full-time employees?*
Number of part time employees?
Number of Volunteers?
   
Yes
No
Yes
No
Yes
No
Yes
No
Who is Served?
Yes
No
Henry County: address where Services are provided?




Henry County: What are the service hours at this location?
Henry County: What is the telephone Number for services?
Yes
No
Stark County:address where Services are provided?




Stark County:What are the service hours at this location
Stark:What is the telephone Number for services?
Yes
No
If No; what ages Qualify?
Yes
No
If no, what income levels qualify?
What is the Fee Structure?*
Yes
No
What percentage of applicants are served that cannot pay for services?
What percentage of applicants don’t qualify for services?
Historical Comparative Data
Question: *(If services are not provided in Stark County use N/A) 2020 2021 2022 2023 Projected 2024
Amount Requested for the specified year?*
KAUW Grant awarded for the specified year?*
N/A
Yes
No
Yes
No
Yes
No
Yes
No
N/A
Total Budget for Henry County Services for the specified year?*
Total Budget for Stark County Services for the specified year?*
Total Agency Budget for the specified year?*
Unduplicated Clients in Henry County by year?*
N/A
Unduplicated Clients in Stark County by year?*
N/A
Number of Henry County clients that requested services but did not receive services by year?*
N/A
Number of Stark County clients that requested services but did not receive services by year?*
N/A
Explanations if needed*:

ATTACHMENTS REQUIRED (DO NOT ATTACH OR SEND IF NOT REQUIRED) Yearly:

  • Annual Budget broken down by program.
  • Current DEI policy statement.

Yearly Only if there has been a change in the previous 12 months:

  • Board of Directors and contact information.
  • A copy of the agency by-laws.
  • Copy of Tax-Exempt Documentation as a Non-profit entity if not previously included.
  • Annual Audit if completed in the last 12 months and performed by an independent auditing firm.
Note:- Support File extension(s) : .jpg, .png, .pdf, .docx, .xlsx

Notes

  • Applications not received by the due date will not be considered. Please contact kewaneeareaunitedway@kewanee.com with any questions.
  • Each agency is expected to participate in the Annual Campaign kickoff and campaign.
  • As specified in the Memorandum of Agreement; a year-end report of outcomes for the previous year is required by January 31st of each year, in order for granted funds to be deliverable for the year for which this application has been completed. Delivery of funds may be delayed until this report is received. If applying for the first time for a grant through KAUW, this requirement is waived.

Thank you for your application! Your Agency will be notified approximately September 1 of the current year.


2023 Agency Grant Application for 2024 Agency Grants Process

MEMORANDUM OF AGREEMENT

Between

ABCD (Area Board for Child Development)

(Here in after referred to as “The Agency”) and

KEWANEE AREA UNITED WAY, INC.

(Here in after referred to as KAUW or “United Way”)

 

Purpose: KAUW is a not-for-profit corporation, whose purposes are to engage in charitable, philanthropic, character-building, health and social welfare work, and all other activities permitted a general not for profit corporation.

Mission: The Kewanee Area United Way is a local, volunteer-driven organization that works to improve the lives of the most vulnerable residents by drawing upon the combined generosity of our communities.

Agency Grants : Agency Grants are allocated to agencies with the strongest local significance in meeting one or more of the three areas of impact supported by United way. The three areas of impact are:

  • Health
  • Educational Success
  • Financial welfare

Constituency:The United Way recognizes the contributors to the annual campaign as its primary donor constituency and pledges responsible stewardship of all donated funds so as to best serve the total community.

GENERAL PRINIPLES – BOTH PARTIES AGREE

Governance:To maintain a responsible governing board of directors whose members serve without pay and are representative of the community served and which meets at least four times a year.

Management:To maintain responsible management to administer its programs and/or services.

Agency Grants:Agency grants are awarded based on the anticipated receipt of donations as calculated from the pledges received during the Annual Campaign/fundraising process from individuals or business commitments. Adjustments to agency grants may occur if pledged/anticipated funding is not received.

Collaboration:To cooperate with each other in the development of sound and acceptable community practices in the field of voluntary service and fundraising.

Non-Discrimination:To maintain a policy of diversity, equity and inclusion in compliance with Federal and State guidelines and/or regulations, and to practice non-discrimination in the delivery of services to clients as per United Way Worldwide policy and regulatory requirements.

THE UNITED WAY AGREES

Agency Autonomy: To recognize the responsibility and accountability of the agency, through its governing board, to determine its own policies and manage its own programs within the scope and spirit of this agreement.

Campaign Planning: To conduct an annual campaign for operating funds and to set goals for this annual campaign with consideration for the financial needs of the member agencies and the needs of the community.

Stewardship: To maintain responsible stewardship on behalf of contributors, participating agencies, and the community-at-large in the collection, management, and distribution of campaign funds; to provide an accounting of agency allocations if requested; and to provide appropriate recognition of donors.

Fiscal Accountability: To keep comprehensive and accurate financial records in conformation with “Standards of Accounting and Financial Reporting for Volunteer Health and Welfare Organizations”; NOTE: financial accounting is provided by the KAUW Board of Director’s Treasurer and Calvert Tax & Bookkeeping in Kewanee, Illinois.

Confidentiality: To respect the confidential nature of information provided by KAUW Agency partners, and to use the contents of the agency’s proposal and financial information for purposes consistent with this agreement. Please note all donations, unless a request for confidentiality has been requested, are public records.

Advocacy:To promote the value and contributions of Agency Partners to the community; to keep channels of communication open to the agency for discussion of matters of common concern; to provide regular opportunities for information exchange and participation; and to assist agencies when requested.

THE AGENCY AGREES

Accountability:To use United Way funding in accordance with the purposes for which it was allocated.

Not for Profit Status:To conform with the laws of the State of Illinois pertaining to not-for-profit corporations.

Tax Exempt Status:To obtain (and to submit upon request) a ruling from the United States Treasury Department that it is not a private foundation; that it is exempt from payment of income tax; and that gifts to it are eligible for a charitable income tax deduction within the limits allowed by law.

Governance:To furnish copies of the constitution, bylaws, and board roster when requested. Should any changes in the Board of Directors/Trustees, the agency agrees to notify Kewanee Area United Way within 30 days.

Agency Policies:To include the following policies as part of agency’s bylaws or policies/procedure manual; Diversity, Equity and Inclusion; ethics, conflict of interest, whistleblower, reserves and frequency of By-Law review.

United Way Support Partnership:To work in partnership with the United Way and other member agencies in meeting the needs of the community, ensuring active agency participation in United Way events, agency leadership meetings, committees, and task forces; providing regular updates as requested. In the case of agencies where funding is renewed each year, an annual report is required and must be provided by January 31st of each year. Please see the note below.

Note: (The Kewanee Area United Way reserves the right, at any time during this agreement to reduce or withhold an agency’s grant, place the agency on probationary status or terminate the agreement if any of the following conditions occur; See section – Termination.)

Annual Report: The annual report will include a comparison of the projected numbers of people to be served on the application for the current year’s grant to the actual number of people served for the previous year, any changes to the program/agency as described in the application, an explanation of changes and an overall brief evaluation of the agency. Failure to submit an annual report may result in a suspension or termination of funding; see Section – Termination in this agreement.

Duplication of Services:To cooperate with other human service agencies, both public and private in preventing duplication of efforts and in promoting efficiency and economy of administration in human service programs.

Participation:If requested, to participate actively in the conduct of the United Way annual campaign. Participation may include fundraising, campaign planning and/or staff to promote and speak on behalf of the Kewanee Area United Way. If participation is requested, all agencies will be expected to attend training if provided.

Employee Campaign:To conduct an annual United Way campaign amongst its employees and to promote voluntary contributions to the United Way among its board and constituency.

Unrestricted Gifts:To encourage unrestricted gifts and to refrain from encouraging designations on donations to the United way’s annual campaign.

Identification:To display the United Way signage in a public area and include identification as a United Way agency where United Way dollars are part of the program or services. Include the United Way logo in appropriate informational/promotional materials (i.e. signage, newsletters, website, and brochures) to identify United Way as a source of funding.

Budget/Allocations:To cooperate in all phases of United Way budget, allocation procedures and fiscal management as requested.

Fiscal Accountability:To keep comprehensive and accurate financial records in conformation with “Standards of Accounting and Financial Reporting for Volunteer Health and Welfare Organizations” and to have these records reviewed or audited annually by an independent auditing firm and furnish copies of this audit to the United Way pursuant to the membership agreement and laws thereof and to maintain adequate reserves. If laws require, to provide the IRS or IL AG Form 990. (Audit to be included in annual Funding Application to Kewanee Area United Way as requested.)

Program Changes:To report to the United Way any major program/budget changes that may affect how United Way allocated dollars are applied. Failure to do so may result in loss of current grant with no option to reapply. In the case of a significant change in the use of funds paid out as described in the Agency grant application, it may be necessary to return all funds paid to this agency after the implementation date of said change.

Community Relations:To immediately notify the United Way of any situation, occurrence or change in agency service delivery, which might have a detrimental effect on the agency or the United Way.

Fundraising:To conduct no fundraising campaigns within the geographical area covered by the KAUW during the span of the United Way annual campaign without prior knowledge and approval from the United Way. BLACKOUT: Generally defined to be September 01 through November 30 of current funded year.

Self-Support:To rely on and plan for fundraising activities that are ethical and effective in meeting agency needs for ongoing operations. To adhere to the values of the United Way in general. To conduct supplemental fund-raising activities in a business-like manner with a spirit of cooperation between the agency and the United Way.

Capital Campaigns:To inform the United Way of planned capital fund campaign in a timely manner prior to the commencement of the campaign.

Annual Review:To annually review this agreement with the board of directors of the agency funded.

TERMINATION

Agency Action:Agencies may withdraw from their agreement with the Kewanee Area United Way. A 30 days’ notice must be given; and may be given only between December 1 or the last day of the annual United Way Campaign and before July 1 of the following year. Withdrawal from the agreement with Kewanee Area United Way must be by written notice from the Board of Directors of the agency. Dissolution of the agreement with KAUW is subject to KAUW’s policy of disclosure to the donors and the general public if requested.

United Way Action:Agency grants may be reduced, placed on hold pending review, or terminated as a result of a vote of two-thirds (2/3) of the Directors present at a meeting of the Kewanee Area United Way Board of Directors. An agency must have had a thirty (30) day notice of pending action via letter and email. An agency shall have been given an opportunity for a hearing by the KAUW Board of Directors prior to termination of an agency grant; except in the case of reduction of a grant due to reduced donations resulting in an overall reduction of grants to all agencies, or if significant changes in the application of funding from the original agency grant application is a result of changes planned or implemented.

The Kewanee Area United Way reserves the right, at any time during this agreement to reduce or withhold an agency’s grant, place the agency on probationary status or terminate the agreement if any of the following conditions occur:

  • Changes in community needs or services and consideration of other factors relevant in the fund allocation process applicable to all agency members.
  • Annual reports are not received by January 31th of the currently funded year. This applies to agencies that have at least 1 full year of grant funds from KAUW. The annual report must compare the projected numbers of people to be served on the application for the current year’s grant to the actual number of people served for the previous year, any changes to the program/agency as described in the application, an explanation of changes and an overall brief evaluation of the agency.
  • Failure on the part of the agency to adhere to the standards and/or policies set forth and covered in this agreement; or failure on the part of the agency to uphold the standards/principles of United Way as a whole. (Diversity, equity and inclusion, non-discrimination, anti-terrorism, non-abusive structure or work environment, or any other principles as specified by the United Way charter.)
  • Failure on the part of the agency to deliver the agreed upon services/program(s) including the agencies participation in Kewanee Area Fund Raising efforts as requested between September 1 and November 30 of the funded year.
  • Significant changes in conditions that result in the inability of the agency to operate the program.
  • Grants may be reduced, placed on hold, or terminated in the event that donation revenue decreases as a result of unforeseen events.
UNITED WAY:
AGENCY:

Counter Terrorism Compliance

In compliance with the spirit and intent of the US counterterrorism laws, the Kewanee Area United Way requests that each funded agency (“Organization”) certify that it is in compliance with Kewanee Area United Way’s and the United Way Worldwide’s (“UWW’) compliance program.

Respond to each statement below in the appropriate box following statement.

ABCD (Area Board for Child Development)
Check the Appropriate Box to indicate agency Compliance with each of the Following: In
Compliance
Not in
Compliance
This Organization is not on any federal terrorism “watch lists”, including the list in Executive Order 13224, the master list of specially designated nationals and blocked persons maintained by the Treasure Department, and the list of Foreign Terrorist Organizations maintained by the State Department.
This Organization does not, will not and has not knowingly provided financial, technical, in-kind, or other material support or resources* to any individual or entity that is a terrorist or terrorist organization, or that supports or funds terrorism.
This Organization does not, will not and has not knowingly provided or collected funds or provided material support or resources with the intention that such funds or material support or resources be used to carry out acts of terrorism.
This Organization does not, will not and has not knowingly provided or collected funds or provided material support or resources to any entity that has knowingly concealed the source of funds used to carry out terrorism or to support Foreign Terrorist Organizations.
This Organization does not re-grant to organizations, individuals, programs and/or projects outside of the United States of America without compliance with IRS guidelines
This Organization takes reasonable, affirmative steps to ensure that any funds or resources distributed or processed do not fund terrorism or terrorist organizations.
This Organization takes reasonable steps to certify against fraud with respect to the provision of financial, technical, in-kind or other material support or resources to terrorists and terrorist organizations.

*In this form, “material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportations, and other physical assets, except medicine or religious materials.

I certify on behalf of the Organization listed above that the foregoing is true.

ABCD (Area Board for Child Development)
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