GSAFE GSA Support 1
Guilford Green Foundation
2005 Grant Application
Please complete this Grant Application in accordance with Attachment A, Guidelines. Submit completed Grant Application and attachments to: Gifting Committee, Guilford Green Foundation, PO Box 10428, Greensboro, NC 27404-0428.
Completed Grant Application must be postmarked no later than June 30, 2005.
I. GENERAL INFORMATION
Name of Organization or Institution (referred to hereinafter as “Grant seeker”):
Gay Straight Advocates for Education, Inc. (GSAFE)
Address: PO Box 41044, Greensboro, NC 27404
Website: www.gsafe.org
Contact information for Grant seeker: Gary Palmer
Contact’s Name and Title: Gary Palmer, Chair.
Telephone: 271-8428 Fax: Email: gary.palmer@replacements.com
If incorporated, please provide date of incorporation (month/day/year): August 26, 2005
II. POPULATIONS SERVED
A. Grant seeker serves the following populations (please check all that apply):
Persons who are:
Lesbian
Gay
Bisexual
Transgendered
The LGBT Community
under age 21
between ages 21 and 65
over age 65
Racial Minorities
Ethnic Minorities
with Serious Health Conditions
Disabled
B. Please describe, in a few sentences, the individuals or communities you serve.
Our primary service is to anyone involved in K-12 education. This includes all students, faculty, staff and administration, regardless of their sexual orientation, health, gender, gender expression, race, ethnic origin, age, or disability.
III. GRANT SEEKER’S OPERATIONS
A. Grant seeker’s General Purpose (please check all that apply):
□ Arts and Culture □ Human Services
Education □ Faith/Religious
□ Health □ Other (please describe below) GSAFE GSA Support 2
B. What is Grantseeker’s organizational or institutional mission?
The Gay, Lesbian and Straight Education Network strives to assure that each member of every school community is valued and respected regardless of sexual orientation or gender identity/expression. We believe that such an atmosphere engenders a positive sense of self, which is the basis of educational achievement and personal growth. Since homophobia and heterosexism undermine a healthy school climate, we work to educate teachers, students and the public at large about the damaging effects these forces have on youth and adults alike. We recognize that forces such as racism and sexism have similarly adverse impacts on communities and we support schools in seeking to redress all such inequities. GLSEN seeks to develop school climates where difference is valued for the positive contribution it makes in creating a more vibrant and diverse community. We welcome as members any and all individuals, regardless of sexual orientation, gender identity/expression or occupation, who are committed to seeing this philosophy realized in K-12 schools.
C. What are the start and end dates of Grantseeker’s current fiscal year?
August 26, 2005 – June 30, 2006
D. What is Grantseeker’s total annual budget for the current fiscal year? $0
E. What was Grantseeker’s total annual budget for the prior fiscal year? $0
F. If budgeted, what is Grantseeker’s total annual budget for the coming fiscal year? $5,105
G. What percentage of Grantseeker’s budget is raised from Grantseeker’s own fundraising efforts?
IV. GRANT FUNDING SPECIFICS
A. Being as specific as possible, what is the particular initiative, project or activity for which funds are now being requested from the Guilford Green Foundation?
We would provide financial support for Gay-Straight Alliances and diversity clubs in schools in Guilford County and support various projects facilitating the successful operation of these organizations.
B. For the particular initiative, project or activity described in (IV.A) above, what is the total dollar amount Grantseeker is requesting from the Guilford Green Foundation?
$2,000
C. What is the total budget for the particular initiative, project or activity described in (IV.A) above? $2,000
D. Have other funds been raised or allocated toward meeting the budget identified in (IV.C) above?
□ Yes No
If yes, how much has been raised or allocated as of the date of this Grant Application?
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E. If the particular initiative, project or activity described in (IV.A) above is an ongoing program, please describe plans for continued funding of this program.
Funds from membership and other donations will be used.
F. What are the start and ending dates for the particular initiative, project or activity described in (IV.A) above?
It would begin on the date the grant award is made and end one year from that date.
V. GRANT RECEIPT SPECIFICS
A. If Grantseeker were to receive a Guilford Green Foundation grant for the particular initiative, project or activity described in (IV.A) above, how exactly would those funds be allocated and used? Please be as specific as possible.
GSAs and diversity clubs would make requests for funding for their organizations. Funds would also be used as available for possible projects like Gay Fine By Me Day, Day of Silence, No Name Calling Week, etc.
B. If Grantseeker were to receive a Guilford Green Foundation grant for the particular initiative, project or activity described in (IV.A) above, please describe the method of implementation, whether staffing will be involved, and the number and type of volunteers, if any, who will support implementation.
GSAFE is an all volunteer organization. Currently, co-chair Annette Green is the facilitator of the Guilford GSA Network and facilitates the monthly meeting for students held at First Friends Meeting on Friendly Ave. Various advisors from area high schools attend these meetings as well as other GLSEN committee members.
C. If Grantseeker were to receive a Guilford Green Foundation grant for the particular initiative, project or activity described in (IV.A) above, what outcome is envisioned? What accomplishments or changes may result?
Our past ability to assist GSAs has made many things possible for them. As silly as it sounds, food is a major attraction for students to attend any type of meeting. Our support means they can serve snacks. They also use the funds for various projects such as banners or tee shirts.
D. What tools or measures will you apply to evaluate the success or failure of a Guilford Green Foundation grant?
The continued existence of a GSA is a success. GSA leadership is always in rapid movement due to the short period of years students are in a high school. Having support from area adults is a good incentive for them to keep the group going. Their participation in our GSA Network is also a sign of success.
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VI. OTHER INFORMATION
A. Is there anything not already covered in this Grant Application you would like the Guilford Green Foundation to know about your organization or institution?
B. Assuming money were no object, what unmet needs in our community would your organization or institution like to see addressed?
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VII. TERMS AND CONDITIONS
As a condition to being considered for any grant the Guilford Green Foundation, in its sole discretion, elects to make to Grantseeker, Grantseeker agrees as follows:
• Grantseeker is a non-profit organization exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code;
• Grantseeker attests that a majority of its membership and/or the population it serves reside in Guilford County;
• Grantseeker agrees to use any grant funds received from the Guilford Green Foundation within Guilford County or for the benefit of residents of Guilford County;
• Grantseeker agrees, as a condition to accepting any funds from the Guilford Green Foundation, that the Guilford Green Foundation may, in its sole discretion, make public the fact that its organization or institution is a grant recipient, the activities or purposes for which such grant is made, and the amount and manner in which any such funds would be used;
• Grantseeker authorizes any publicity or documentation that demonstrates a granter-grantee relationship, should your organization or institution accept funds from the Guilford Green Foundation;
• Grantseeker agrees, as a condition to accepting any funds from the Guilford Green Foundation, that any funds granted by the Guilford Green Foundation be used solely and exclusively for the purpose, and within the time period, requested in this Grant Application, and that any differing use(s), or any use(s) within any differing time period(s), be pre-approved, in writing, by a vote of the Guilford Green Foundation Board of Directors;
• Grantseeker agrees to provide the Guilford Green Foundation, in a timely fashion, with a six month progress report, as well as a final evaluation, if appropriate, of its activity; and
• Grantseeker agrees, as a condition to accepting any funds from the Guilford Green Foundation, to promptly repay to the Guilford Green Foundation the grant monies received in the event (i) your organization or institution makes any unauthorized use(s), or any use(s) within any differing time period(s), that materially differ from the use(s), and/or time period(s), provided for in the Grant Application, (ii) that you fail to make a timely progress report, or (iii) that this Grant Application contains any material misstatement or omission.
I hereby certify that I am authorized to sign this Grant Application on behalf of (please insert Grantseeker’s name) ________________________________________, that I have fully read this Grant Application and Attachment A, that I understand and agree with its terms and conditions, and that, to the best of my knowledge, this Grant Application is true, correct, and complete.
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Signature Date
__________________________________________________________________________________
Type or Print Name Title or Authority of Signer
Applications must be postmarked no later than June 30, 2005.
Submit completed Grant Application and attachments to:
Gifting Committee, Guilford Green Foundation, PO Box 10428, Greensboro, NC 27404-0428 GSAFE GSA Support 6
