Capacity Building Grant Proposal 2011-2012
Organization Name:
Mailing Address:
City: Zip Code:
Address Line 2: County:
Counties Where Service Will Be Provided:
Tax ID Number: (9-digit number, no hyphen)
Executive Director:
Project Director:
Project Director Email:
Project Director Phone Number:
Basic Information
Has This Organization Received Funding from The OBB in the Past?
Purpose and Amount of Past Funding:
Capacity Building Grant Proposal 2011-2012
Background Information
Organization’s Mission A brief summary of your organization’s overall mission and purpose. (100 words or less)
Organization’s Goals and Objectives A brief outline of your organization’s overall primary goals and objectives. (100 words or less)
Overview of Programs A list of the programs your organization operates and a brief description of each. (100 words or less)
Number of Families/Individuals Served in State Fiscal Year 2011*, and method(s) for
tracking amount served (*July 2010-June 2011)
Capacity Building Grant Proposal 2011-2012 Narrative Provide an overview of how your organization would benefit from OBB Capacity Building funds and how funding
would assist your organization in expanding the services it offers. (500 words or less)
Capacity Building Grant Proposal 2011-2012 Scope of Services
Outreach Efforts List strategies your organization will use to attract Benefit Bank clients. Identify any events you are planning that
will be targeted at increasing the number of clients served. Also outline plans for the use of at least the required 5%
of your total budgetary request for outreach. Please do not include free OBB marketing materials. (300 words or less)
Plan to Address Potential Barriers to Service Provide a brief description of challenges your organization will need to address to be the most effective Benefit
Bank site possible. Include a plan for addressing these challenges. (300 words or less)
Capacity Building Grant Proposal 2011-2012 Scope of Services, continued
Activities and Outcomes of Tax Season Describe, in detail, the actual services you plan to provide to your clients and the outcomes you hope to achieve.
Include a plan for at least one tax clinic or other event held outside of normal business hours (requirement of
grant). This event can involve outreach through OBB Self-Serve, partnership with the OBB Mobile Express, or
traditional tax clinic events. See www.ohiobenefits.org/taxclinickit.html for more ideas. Also include any wrap-
around services your organization plans to offer as part of tax season, such as financial literacy or benefits
outreach. Be prepared to elaborate on this description in the following Work Plan. (500 words or less)
Capacity Building Grant Proposal 2011-2012 Scope of Services, continued
Collaboration Describe existing relationships with other community-based organizations and Ohio Benefit Bank sites, and how you
will capitalize on these relationships to maximize services provided. If you do not have any existing relationships,
describe how you will strive to foster collaboration to help your organization reach its goals. (300 words or less)
Capacity Building Grant Work Plan 2011-2012
Organization Name:
Formula for Numerical Goal
Explain how you intend to reach your numerical goal. For example, if each tax return takes 1.5 hours to
complete, you might calculate your goal by finding (number of OBB counselors) X (number of hours
worked in tax season per counselor) / 1.5 to reach an approximate, reasonable numerical goal.
Numerical Goal for Federal Tax Returns Completed:
The Work Plan Goals below should reflect steps that will be taken each month to reach your
overall goal for tax season. Use specific target dates (i.e. February 15, 2012) as well as specific
measurable outcomes of each step (i.e. Assist 30 clients at first tax clinic).
Each month, you will submit a report updating your Work Plan with the results you have
attained. There should be multiple Work Plan Goals in each month of the grant period. Focus on
making the goals as detailed, realistic, and measurable as possible.
Month Work Plan Goals
November
December
Capacity Building Grant Logic Model 2011-2012
Logic Models are used by organizations to help them to address specific needs through strategic programmatic planning. As part of your
application for funding, please complete the following logic model, detailing 1) The specific need(s) for service(s) that exist in your service area,
2) The step(s) your organization intends to take in order to address those need(s), and 3) The outcome(s) your organization plans to reach.
Please be specific; include geographically appropriate statistics, well thought-out activities with targeted outreach and implementation plans,
and both qualitative (i.e. better quality service) and quantitative (i.e. 75% increase in clients) outcomes.
1) Need(s) 2) Activities 3) Outcomes
Organization Name:
Capacity Building Grant Budget Narrative 2011-2012 Organization Name:
Salary/Wages *all amounts should include fringe benefits
OBB Tax Counselor(s) [# ]
OBB Site Administrator
Other:
Months Hrs/Month Rate/Hr Total
Total Salary:
Computer Equipment
PC (Hard drive, keyboard, mouse, cables)
Computer Monitor
Laptop
Printer
Other:
Quantity Rate Total
Total Computer Equipment:
Other Costs
Marketing (must be at least 5% of award)
Office Supplies (paper, ink, etc.)
Mileage (at 55 cents/mile)
Administrative (up to 10% of award)
Other:
Description Cost
Total for Other Costs:
Total: