2015 Oklahoma Bar Foundation Grant Application Forms 2015 Cove r She e t (OBFGrt-Forms-2015-Part2of2.pdf) Applicant Information Organization: Program/Project: Address: City/State/Zip: Telephone: E-Mail: Executive Director: Program Dir/Mgr: Application Contact & E-Mail: Project Information Category or categories for which you request OBF grant funds: Legal services to the disadvantaged Other Law related education (define) Administration of justice Total Request Amount: $ Tax ID#: Funds Requested for: Specific Project Previous OBF Grant Funds: . General Support (required) Other: _ ______________________________________ Year of Prior Grant Awards Grant Amount $ $ $ Your Geographic Area Served: Brief summary of grant request (the main description of your request should be contained within the application body following this cover sheet): Applicant Agreement (applicant) agrees to carry out the activities described in this application, if granted funds as requested herein by the Oklahoma Bar Foundation, and shall report to the Oklahoma Bar Foundation on progress and results from using all such grant funds. Date: Title: Signature: For OBF Use - Do no write below this line Application #______________________ Date Received_____________________ Status_______________________ Amount_________________________ Please print and read the OBFGrt-INSTRUCTIONS-2015-Part1of2.pdf file before completing the grant application process. Thank you. 2015 Oklahoma Bar Foundation Grant Application Forms F i n a n ci a l I n f o r m a t i on a n d B u d g e t S h e e t Your Program Name: 2014 Actual (or last year) 2015 Budgeted (or current year) 2016 Projected Budget (or next year – request year) $ $ $ XXXXX XXXXX XXXXX $ $ $ $ $ $ XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX Total Expenses In-Kind Donations In-Kind Services TOTAL EXPENSES (Including In-Kind) $ $ $ $ $ $ GAIN/LOSS $ $ $ Ending Fund Balance $ $ $ Beginning Fund Balance REVENUE (disclose all revenue) OBF Grant Award here: Total Revenue In-Kind Donations In-Kind Services TOTAL REVENUE (Including In-Kind) EXPENSES Salaries ( itemized list required) Benefits/Payroll Taxes Office Space Telephone Supplies Postage Equipment:* Rent/Lease Maintenance/Repair Depreciation Expense** Printing and Photocopying Travel & Education Auditing Insurance Software/Internet Subscriptions: Other Program/Project Expenses: Capital Purchases To Be Made*** $ * Equipment Expense does not include capital purchases, see bottom line. ** Depreciation Expense should reflect the annual depreciation of equipment owned by the organization. *** If you plan to use OBF funds for Capital Purchases, please describe & explain reason for purchase on separate sheet; attach 3 quotes. ►ATTACH YOUR ORGANIZATION’S FINANCIAL STATEMENTS AND YOUR IRS FORM 990 FOR THE TWO MOST RECENT YEARS. 2015 Oklahoma Bar Foundation Grant Application Forms OBF Grant Application Final Checklist Prior to submitting your application, please review all submission instructions to ensure your application is complete according to requirements; instructions are contained in a separate file – OBFGrt-INSTRUCTIONS-2015-Part1of2.pdf . The following checklist is included for your convenience and you need not return the checklist with your application submission. My OBF Application Packet: Because the organization of the application has changed, we carefully review “2015 Grant Application Instructions and Requirements” before completing the OBF grant application packet. Includes 1 original and 14 copies – printed on unbound 8 1/2" x 11" paper, all legal-size attachments are reduced to 8 1/2” X 11” size, with only one staple in upper left corner of each; Is being submitted to the Oklahoma Bar Foundation not later than 5:00 pm CST on Tuesday, May 26, 2015 – the application is either being mailed, delivered in person or via messenger. (applicants are strongly encouraged to submit application packets early); Includes a complete, signed 2015 Cover Sheet using the form on first page of the application packet (nothing should be placed before the 2015 Cover Sheet); Includes a complete program overview describing the funding request and all other pertinent information as required in the “2015 Grant Application Instructions and Requirements”; Includes a Budget Narrative as well as the Financial Information and Budget Sheet (figures are in balance and the funding request amount matches the total shown on the 2015 Cover Sheet); Includes 2 copies of our audited financial reports and organization financial statements for the two most recent years; Includes 2 copies the last two year’s IRS Form 990’s or other tax report forms; Includes important information relating to possible grant funding in a “lesser amount” along with priorities; Includes all attachments and supplemental documents – all on 8 ½” X 11” sized sheets. Includes a current itemized listing of staffing positions and salaries; job descriptions are included for all positions that are to be funded in total or in part by any portion of the OBF request; Incomplete grant applications will be returned for timely completion or clarification. A t t a ch e d f o r Y o u r I n f o r m a ti on on l y a r e : Sample copy of the “OBF Grant Quarterly Report Form” Examples of the “Narrative Story On Your Program” – 2 stories per grant period are required. Grant Agreement A grant agreement, to be provided by the Oklahoma Bar Foundation upon notification of the grant funding award, must be executed by the grantee and returned to the OBF office before grant funding will commence. A pp l i ca t i on P a c ke t s Grant application packets, and supporting materials, become the property of the Oklahoma Bar Foundation and will not be returned. OBF has the right to use any or all information provided in the application submission, whether or not the proposal is accepted. For further information, please contact the OBF at (405) 416-7070 or [email protected] 2015 Oklahoma Bar Foundation Grant Application Forms Okla ho ma B ar Fo unda tion Gra nt Qua rterly Repo rt Form TO: Nancy Norsworthy, Executive Director Oklahoma Bar Foundation P O Box 53036 Oklahoma City OK 73152-3036 Phone: (405) 416-7070 or (800) 522-8065, Ext 7070 E-mail: [email protected] FROM: Your Contact Name: Organization: Program/project funded: Address: City/State/Zip: Contact Phone: Contact E-mail Address: Preparation Date: Report Period Covered: OBF Grant Period: 2015 OBF Grant Period Payable for Calendar Year 2016 Full Amount Granted: BRIEF PROGRAM DEFINITION: INTRODUCTORY STATEMENT: RUNNING TOTAL ALL GRANT EXPENDITURES TO DATE: Expense Category Description TOTAL THIS REPORT PERIOD ONLY = PAGE 1 OF 3 QUARTERLY GRANT REPORT FORM (running total grant period to date) Expended Amount this Report Period 2015 Oklahoma Bar Foundation Grant Application Forms QUARTERLY HIGHLIGHTS: REPORT ALL APPLICABLE STATISTICAL INFORMATION: PROBLEMS ENCOUNTERED: YOUR PROGRAM GOALS AND PROGRESS/SUCCESSES (your outcomes): As defined in your Grant Application required under Section 6 of the Grant Application Instructions. PRO BONO EFFORT HIGHLIGHTS (volunteer efforts): Include number of volunteers & estimated hours worked as well as other highlights and how many are attorney volunteers. ADDITIONAL INFORMATION, INCLUDING PUBLIC RECOGNITION OF THE OBF: Attach press release information – notices – clippings. PAGE 2 OF 3 QUARTERLY GRANT REPORT FORM Please attach added sheets when space is not adequate. 2015 Oklahoma Bar Foundation Grant Application Forms One-Time Annual Grant Narrative Requirement for each OBF Grant Award to be submitted by all organizations receiving OBF funding: Provide not less than five (5) brief narrative stories about your program and/or project for OBF publication purposes. These should be client success stories that have not and will not be published elsewhere. OBF is interested in personal testimonials and stories that will provide an emotional response from readers to generate donations rather than normal facts, figures and statistics. Two examples follow below. David & Jordan – Oklahoma Lawyers for Children Example No. 1 David and Jordan are brothers living very different lives than when they first came into DHS custody 3 years ago. The boys were 15 and 14 when removed from their parents for neglect. David, now an easy going 18 year old is far older than his age, “We knew we had to stick together when we got picked up. Our life wasn’t the best, but it was our life and it’s what we knew.” The boys had lived in motels all of their lives, often missing school when their parents were “dope sick” and needed “help.” David explained “help” meant he had to go score drugs for his parents and watch them shoot up. The boys arrived at the Shelter with their guard up and lots of attitude. A lot of that changed after they met their Oklahoma Lawyers for Children lawyer. Eventually, OLFC got them out of the Shelter, but not placed together. The street tough brothers would run off to meet each other and it was stressful for the foster families. When David aged out, he lived on the streets for a while, but stayed in touch with his OLFC lawyer. Eventually David figured out he didn’t want to be like his dad, and his OLFC lawyer helped him get a job and his GED. Now David attends OCCC and has a future. Jordan is at Guthrie Job Corps working on his GED and learning to be a welder. David is quick to remind young Jordan not to waste time saying, “Dude! Stay in Job Corps, get your GED and a trade!” The boys credit their OLFC lawyer for sticking with them and seeing them as individuals with different needs. “Man we were on a bad road to nowhere!” says Jordan. “Our mom and dad, they weren’t changin’…Our lawyer cared!” The boys now look forward to the future, a future where hope and color have been returned to the lives of neglected children thanks to grant funding provided by the Oklahoma Bar Foundation for OLFC pro bono programs. Rose – Senior Law Resource Center Example No. 2 Within months of her diagnosis, Rose received news that her cancer had spread. The doctors said it was terminal. Rose gradually began to lose her strength and her mind as the disease took over her body. Rose’s thoughts raced -- How could she care for herself in this condition? Rose called her adult daughter, Karen, who immediately sold her home and personal possessions to move in to Rose’s home and care for Rose. Soon Karen learned how difficult it was to care for a parent. No one would speak with her about Rose’s care. They would not allow her to review Rose’s medical bills, purchase insurance, or even speak with them about paying the debts Rose owed. At a loss for what to do, Rose and Karen contacted the attorneys at the Senior Law Resource Center. The Center provided advice and documents to Rose that allowed Karen to care for Rose and speak to others on her behalf. The Center also helped Rose repay Karen’s generosity by helping with the legal documents needed for Rose to be able to leave her home to Karen after her death. Now, Karen does not encounter problems caring for Rose. Karen can focus on caring for and spending time with her mother in Rose’s final days thanks in part to grant funding provided by the Oklahoma Bar Foundation for Senior Law Resource Center programs. PAGE 3 OF 3 QUARTERLY GRANT REPORT FORM
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