LIVE UNITED Grant Application | United Way of the Eastern Panhandle

2024 - 2025 LIVE UNITED Grant Application

It is not necessary to log in to use this application. If you are unable to finish your application, press "Save Draft" and you should be able to complete it by revisiting this page on the same device. If you have any difficulties doing so or have other questions about the application process, please reach out to Nicholas Malin at nmalin@uwayep.org or at (304)263-0603 (Ext. 123). Only electronic versions of the application will be accepted.

You will be required to download the following document, complete it, and upload it into this application tool.

Program Financial Data & Proposed Budget

Click here for LIVE UNITED application guidelines.

Agency's Name

Street Address

City

State

Zip Code

Mailing Address (if different)

Agency's Phone Number

Agency's Fax Number

Agency's website address

Number of Employees

Agency Mission Statement

Program Name

Program Summary

Please describe who will be served by the proposed program.

Goals

Amount Requested (cannot exceed $5000)

Impact Area:

Primary Contact's First Name

Primary Contact's Last Name

Primary Contact's Email Address

CEO's First Name

CEO's Last Name

CEO's Title

CEO's Email Address

Current Annual Budget

United Way Request as a % of Total Budget

Please describe how your organization will use the requested grant funds.

Provide the number of unduplicated individuals served by this program in Berkeley County

Provide the number of unduplicated individuals served by this program in Jefferson County

Provide the number of unduplicated individuals served by this program in Morgan County

What else would you like us to know about your program

Desired Outcomes

Did Your Organization Receive Funds from UWEP in 2023-2024?

Does your organization have a profile on VolunteerEP.org?

Has your organization participated in the Quarterly Partner Agency Meetings this year?

Has your organization supported the United Way community campaign this year?

If yes, mark all that apply:

Other

Did your organization participate in the Unity Campaign?

Did your organization participate in Day of Caring?

Please attach a Copy of your Program Budget

One file only.
200 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Please attach a copy of your most recent 990

Please upload a Copy of your 501(c)(3) Tax Exemption Letter from the IRS

Does your agency have a Whistle Blowers policy? If no and approved for funding, you will be asked to create one. A sample is available.

Does your agency have a Conflict of Interest policy? If no and approved for funding, you will be asked to create one. A sample is available.

Does your organization have a statement on Diversity, Equity and Inclusion (DEI)?

If yes, include statement below:

Has your organization provided any DEI training to board members and/or staff?

If yes, please describe:

What challenges and barriers does your organization face to address disparities and incorporate DEI into your funded program? What resources would be helpful in this effort

I hereby certify and affirm that all statements and documents enclosed in this application are accurate.

Name

Title