Verizon Foundation

Sample Grant Applications

Event / Sponsorship Grant

Please note that this sample application is for reference use ONLY. You must log in to actually submit a proposal.

Contact Information
Please provide the following information so that we may contact you regarding your proposal.
1) Salutation Preferred salutation (Ms., Mr., Mrs., Dr., etc.)
2) Last Name (required)
3) First Name (required)
4) Middle Name
5) Title (required)
6) Contact Type (required)
7) Address (required)
8) City (required)
9) State (required)
10) Province
11) ZIP Code (required)
12) Telephone (required)
13) Fax
14) E-mail Address (required)

Organization Information
Please provide the following information about your organization.
1) Legal Name (required)
2) AKA Name Your organization may also be known as...
3) In Care Of Name Legal name of the organization corresponding to the specified tax ID. This is used only if your organization lacks its own tax ID or is applying for funding using another organization's tax ID. Actual funding will be provided to the In Care Of organization.
4) Relationship to 'in care of' organization
5) Address (required)
6) City (required)
7) State (required)
8) ZIP Code (required)
9) Province
10) Country (required)
11) Telephone (required)
12) Fax
13) Web Site Address
14) E-mail Address
What is your mission, your vision, and any key points of approach? We see mission as what you do and vision as the end state you wish to achieve. The best mission and vision statements are short and clear. We are especially interested in how your mission gives you concentration and focus—discouraging you from simply taking on more projects because money is available. Finally, if you have values, principles, strategies that guide where you go or how you work, please include them and be specific about how they shape your actions.
15) Organization Mission (required) 500 character maximum
16) Organization Vision (required) 500 character maximum
17) Organization Key Points (Values, Principles and Strategies) (required) 500 character maximum
18) Please summarize your strongest achievements in the past three years - meaning those who benefited. (required) Please speak to accomplishments from participants, not programs themselves. Also please specify how many people have tangibly improved their life than on how much money you have attracted or what awards you may have received—unless the recognition is clearly based on participant outcomes. 500 character maximum
What demographics do you serve and what ethnic reach does your organization have overall? We are trying to get a sense of the magnitude of the problem within your demographic/ethnic focus. When it comes to the number, just rely on existing data - whether it comes from the Internet or from estimates by those in your area in the best position to know.
19) Community Ethnicity (required) Please provide an ethnicity distribution for the community that your organization generally works to support. While this information will not have any weight in the decision of your proposal, it is still required for our internal tracking purposes.	% American Indian or Alaska Native % Asian or Pacific Islander % Black or African American % Hispanic or Latino % White or Caucasian % Other/Unspecified
20) What other demographic groups do you serve? (required) Does your organization work with a particular age group, gender, or other segment of the population? 500 character maximum
In your geographic area, whether local, state or national, what are the three organizations that are most similar to you? And what differentiates you from them? Few groups are so unique that they have no comparable organizations. We want to know who you see as most similar so that we can look at a broader picture of organizations approaching the same issues within an area and gain a sense of how you are different. This question encourages you to tell us what we should remember about you, what makes you stand out in some way.
21) Three similar organizations (required) 500 character maximum
22) What makes you different? (required) 750 character maximum

Organization Certifications

All applicants must answer the following questions regarding their organization in order to be considered for a Verizon Foundation grant. PLEASE NOTE: Answering no to any of the following questions does not imply ineligibility.

1) Does any Verizon employee, customer, or board member have a financial interest? (required)

2) Are there any branch offices, operations, or representation in U.S. sanctioned countries? (required)

3) Board, staff and organization are free of indictments, convictions, and conflicts of interest (required)

4) Organization has one separate financial or accounting person or function. (required)

5) Organization has conflict of interest policy and procedures (required)

6) The organization has at least 3 board members (required)

7) If answering "no" to any of the above questions, please explain. (required)
NOTE: Answering "no" to any question does not imply ineligibility. If answering "yes" please populate this field with N/A.

8) Organization Accuracy Certification (required)
I certify that all preceding organization information (including the Legal Name, Address, and certifications) is accurate and complete as of today's date. I acknowledge that any information that is found to be inaccurate or incomplete could possibly delay or disqualify any funding that this organization might receive.

Proposal Information
Proposal Title (required) Please enter a descriptive title for your proposal.
Request Date (required)	(MM/DD/YY)
Request Amount (required)
Proposal Budget
Funding Areas (required) Please select from one of the following funding principles as they pertain to your proposal.
Proposal Start Date	(MM/DD/YY)
Proposal End Date	(MM/DD/YY)
Please specifically state/explain for what purpose Verizon Foundation's funding will be used. (required) approx. 10 page maximum
What overall approach or strategy are you using to achieve results? (required) Please note any evidence that exists, that illustrates this strategy’s ability to achieve your results. If this proposal is not evidence -based, explain the process by which this strategy was developed. Most programs/projects are not a random set of activities. They are a coherent approach to achieve a result. Please tell us about the core elements of your particular way of solving a problem and why you think it is the best way to engage participants and help them get to the success you have stated. If the approach is evidence-based (in the sense that information exists to show its power to achieve results), tell us what it is. A quick summary and reference to a web site with relevant research is fine to include. 1000 character maximum
Specifically state the social cause/issue you intend to address. (required) 2000 character maximum
Include additional funding, if any. (required) Relative to additional program/project funding, be sure to include: Name of Funder Amount of Funding Where this funding is directed	approx. 10 page maximum
How will you know when your expected results have been achieved? What information or evidence will you use to verify success? (required) 2000 character maximum
What approaches will you use to communicate Verizon’s role as your partner in this work? (required) Please define the different ways in which our support will be known and to what groups. We join with you in wanting to communicate both your successes and learning, and our partnership for this area of critical work. For us it is a branding of our foundation - and the corporation that makes it possible - as a positive gain for the communities we serve. 2000 character maximum
Number estimated to see Verizon as your partner. (required)
Proposal Budget Breakdown Grant requests of $10,000 or more are required to include a breakdown of the proposal (i.e., dollars requested from Verizon Foundation) by either uploading a budget template or answering the Organization Income, Verizon-Funded Budget, and Overall Project Budget questions below. Please click here to download the foundation's budget template to your computer. When you have finished working on the breakdown, save the document, close out of MS Word, and then click on the Upload link to finish attaching the completed document to your application. Upload File (Click for instructions)

Communities Served
Please provide the following information about the community that your organization works to support. While this information will not have any weight in the acceptance or rejection of your proposal, it is still required for our internal tracking purposes. If you do not typically track this kind of information, then please provide your best estimate for each category. The perecentages for each category should add up to 100%.
Estimated Population Served (required) Please provide a breakdown by percentage of the Population that this proposal will work to support.	% Disaster Victims % Family % Gay / Lesbian / Transgender % General Public % People with Disabilities % Teachers % Underprivileged
Estimated Ethnicity Served (required) Please provide a breakdown by percentage of the ethnicities that this proposal will work to support.	% American Indian or Alaska Native % Asian or Pacific Islander % Black or African American % Hispanic or Latino % White or Caucasian
Estimated Age Group Served (required) Please provide a breakdown by percentage of the Age Groups that this proposal will work to support.	% Adults % All % College % Elderly % K - 12 % Preschool
Estimated Gender Served (required) Please provide a breakdown by percentage of the genders that this proposal will work to support.	% All % Females % Males

Grant Agreement Clauses

PLEASE NOTE: All applicant organization must complete the following certifications. If the certifications are found to have been completed inaccurately, the organization seeking support may be required to return any granted assets, and may be rendered ineligible for future support.

1) Religious Proselytizing Restriction (required)
Check "I confirm" to certify the following: The program described in this proposal is solely engaged in direct service provision. Exposure, adherence, or conversion to any religious doctrine is not required of the programs beneficiaries. If a grant is awarded, the organization will not use it for the purposes of religious proselytizing in any way.

I Confirm

2) Non-Violence and Anti-Terrorism Certification (required)
Check "I confirm" to certify the following: The organization (as well as any partners, re-grantees, or subsidiary or affiliated organizations) does not support, directly or indirectly, any terrorist activities or violence of any kind, nor does it employ or deal with any entities or individuals known to support terrorism. The organization certifies that it takes reasonable steps to ensure that grant funds are not ultimately distributed to terrorist organizations or for violent purposes; and takes reasonable steps to ensure that staff, board, and other volunteers have no dealings whatsoever with known terrorists or terrorist organizations.

I Confirm

3) Lobbying and Political Use Restrictions (required)
Check "I confirm" to certify the following: The organization will not knowingly use the grant, directly or indirectly, to influence legislation, to influence the outcome of any specific election for candidates to public office, to carry on any voter registration drive, to induce or encourage violations of law or public policy, to cause any improper private benefit to occur, or to make any grant to an individual other than as a part of the charitable activities in support of this project, nor to undertake any activity not in support of the project for which funding is requested.

I Confirm

4) Use of Funds (required)
Check "I confirm" to certify the following: The Organization will use the grant only for the purposes and activities specified in the grant application. If the Organization is dissolved, or if it is otherwise unable to use the grant for the specified project, the Organization will promptly return any unexpended grant funds to Verizon Foundation. If any portion of the grant is used for purposes other than the requested project, the Organization will promptly correct the error. If the misuse is not promptly corrected, Verizon Foundation may demand the return of the entire grant, and the Organization will return the grant to Verizon Foundation. If the Organization concludes that it is necessary to modify the plans for project in order to comply with requirements of any law or regulation affecting its responsibilities under this grant, or it becomes aware of facts or circumstances affecting its ability to implement the project or the propriety of such implementation, the Organization will promptly notify Verizon Foundation in writing, and together we will take the steps necessary to resolve the situation.

I Confirm

5) Confirmation of Charitable Intent (required)
Check "I confirm" to certify the following: We further certify that none of the proposed grant funds will be used to provide any direct benefit to The Verizon Foundation Company, to any Verizon Foundation employee or any employee's family member (except in the provision of charitable services or education available to the public at large), or to any staff member, board member, or donor to the Organization. No goods or services have been offered or promised in consideration for this charitable contribution. I further certify that to the best of my knowledge, information, and belief, the purpose of this grant is charitable and for the good of the community, and is not intended to fulfill business purposes or obligations of any kind including but not limited to offset, sales, or procurement commitments.

I Confirm

6) Acceptance of Review (required)
Check "I confirm" to certify the following: I understand that all applicants are subject to review of their representations in this application and (for grantees) their compliance with the grant agreement. I understand that the organization I represent may be required to return any granted assets and forfeit future funding eligibility if: (1) the review reveals any significant inaccuracies or violations of the policies stated above or (2) the organization does not cooperate with the review.

I Confirm

7) Board Review and Approval of this Application (required)
Check "I confirm" to certify the following: At least one officer of our nonprofit organization's board or executive of our nonprofit organization has reviewed this application, and the entire board has knowledge of and supports its submission.

I Confirm

8) Grant Accuracy Certification (required)
Check "I confirm" to certify the following: I certify that: (1) I completed this form, and the information I provided is complete and accurate, (2) the organization that I represent complies fully with the policies stated in the criteria and guidelines section on the introductory web page at the beginning of this application form, and (3) any assets awarded will be used only in the manner specified in this application.

I Confirm

Volunteer Spotlight:

Kathy McCrystal mentors three young children in her community, giving them a trustworthy adult with whom they can share problems and fun activities.