Answer questions to see if you qualify

Note the following:

Applications must be authorized and submitted by an existing non-profit organization. If the organization is not an Episcopal Church, a copy of its tax exemption certificate from the I.R.S. must be enclosed. The Society’s charter and bylaws require that organizations receiving grants be located within the geographical boundaries of the Diocese of Massachusetts (the portion of Massachusetts east of Worcester County).

Please Select All the text below and copy it into a New Blank Document. Clearly answer all of the questions provided, and be sure to include the required attachments (#17 on the form) with your submission. Email the completed application to our administrator at tchs@diomass.org.

Administrative
  1. Name and address of the non-profit organization running the program.(Programs are restricted to Massachusetts east of Worcester County)
  1. Name, Address, Federal Employee Identification Number (EIN) number, and Website of the non-profit organization or the fiscal agent organization that will receive funds for your program
  1. Contact person for the program including email and phone
  1. Site visit address
  1. What is the dollar amount of your request? What is the projected annual budget for your program? (Please attach budget sheet)
  1. If applicable, what is the projected annual budget of your fiscal agent organization?(Please attach budget sheet)
  1. What line item in your program budget will The Church Home Society grant monies support per your program budget supplied in response to Question 17.
  1. What are your current and prospective funding sources not only for your program but also for your fiscal agent institution? Applications must include all existing and prospective sources of funding for the associated program/project.
Program Overview
  1. What are the ages of the youth your program will serve? In what ways are the youth currently underserved (ex: what are their economic, cultural, educational or spiritual needs)?
  1. How many youth does this program support? How many in the wider community?
  1. If this program is not a new program, what year did this program begin?
  1. Please describe the overall nature of your need. Is it…
  • …to start up a new initiative?
  • …to stabilize a program started in the last three years?
  • …to expand a tested program to new locations? If Yes, where?
  • …to help an existing program get back on its feet?
Program Details
  1. Over what length of time will the youth be in the program? How often will the youth meet? (sample answer: three months, October thru Dec, meeting weekly from 6 to 8 on Wednesdays, etc.)
  1. Does your program (check all that apply): Applications must detail how the goals and strategies of the requested program/project conform to the Society’s grant guidelines.
    • Involve young persons in the planning and/or execution of the program?
    • Empower youth through cultivating skills, and encourage healthy living?
    • Equip youth with Leadership Training?
    • Promote, in their aim and execution, goals that are compatible with the Christian view of life and society, which values all creation as the work of God and seeks reconciliation and love among human beings?
    • Provide service-oriented or community building efforts, such as:
      • Paid or volunteer group projects for youth, especially during the summer?
      • Youth projects providing assistance to the elderly, handicapped, etc.?
      • Youth environmental projects, such as education or cleanup?
      • Vocational assistance such as job counseling and employment of youth?
      • Group volunteer opportunities?
      • Other (please explain)
  1. Please summarize the program goals and the program structure you have designed to meet those goals. Please limit your response to no more than two pages.
  1. How will you measure success? Please limit your response to no more than one page.
  1. Please attach the following to complete your application:
    • Budgets:
      • Applications must include a detailed budget sheet for your grant request’s specific program or project. Please explain any surplus/deficit for your program/project.
      • Include your organization’s total overall budget. Please explain any surplus/deficit.
      • If applicable, include your fiscal agent or sponsor’s organization budget.
      • The budget (or budgets) must contain a clear indication of how the requested grant money would be spent and a list of grants pending or promised. Also include a copy of the prior year financial statements for your organization and your fiscal agent/sponsor (if any).
    • Staff list
    • Accountability Persons: As applicable, names of the Board of Trustees, Advisory Board, Church Governance Board, Pastor(s)
    • If you have received a Church Home grant within the past three years, please fill out and include with your application this Post-Award Grant Evaluation Form.
    • Copy of the applicable 501(c)(3) form for the non-profit organization receiving the check for the program.

  1. At 10 months into program/project you will receive a request to complete a Post-Award Grant Evaluation Form; please help us assess the efficacy of our grant-making process by filling out and returning the form to Church Home as soon as possible.