Servant's Heart Grant Application Questionnaire

We thank you for your interest in Servant's Heart Foundation
and welcome you to apply for the grant.

When you have answered all of the questions, click the Submit button at the end. Once we have received your submitted Interest Form we will contact you within 30 days regarding potential next steps. If you have any questions please reach out to us by email to: Lindsey@pkservantsheart.org and copy Ellie@pkservantsheart.org or call (949)759-3456.

GUIDESTAR: Questions with a GuideStar Symbol have been pulled from your organizations GuideStar public information in order to save you time. You are able to edit any of the information in the answer. Please double check all GuideStar information for accuracy.

Project Name:
Name of Project or area the Grant is serving:

character limit: 100
Describe The Project:
Give a brief description of the project you are applying the grant to.

character limit: 1500
Amount Requesting:
U.S. Dollar Amount Requested for your project:

Is this a multiple year grant?:
Describe amount and the U.S. dollar amount per year are requesting:

character limit: 500
How much Kingdom impact will our gift make?
1 is lowest impact probability score, 5 is highest impact probability score:
Comments:

character limit: 500
Long-term VISION:
Briefly describe the long term vision for this grant/project.

character limit: 500
How do you define success for this grant?

character limit: 3000
What are your Impact Strategies?
Describe the strategies to create this impact.

character limit: 1500
Describe the Impact Indicators:
How will your organization know if you are making progress?

character limit: 1500
Is this a one-time need for funding or will it lead to future needs?
Comments:

character limit: 500
Specifically, how will the funds be spent?
You may also upload a supportive document by selecting the Choose File button below.

character limit: 1500

File Path:
Will the impact of this gift be measurable, and how will you go about measuring its impact?

character limit: 3000
How much money is currently committed to this project?

character limit: 500
Has the request been presented to anyone else?
If YES - please provide details here:

character limit: 500
Any Additional Comments:

character limit: 3000

LEADERSHIP


CEO Name & Tenure:

character limit: 250
CEO Age:

Total CEO Yearly Compensation:

Comments: (Optional)

character limit: 500
Does the CEO receive an annual evaluation?
If YES - by whom?
Name and/or Title:

character limit: 250
Who does the CEO report to?
Name and/or Title:

character limit: 250
Does the CEO serve on the Board?
Comments: (Optional)

character limit: 500
Is the CEO Successor Identified?

character limit: 500
How many Board meetings do you have annually?

Who is your Board Chair & Tenure?

character limit: 250
Does your Board have Term limits, and if so, what is the Term length?

character limit: 1500
Is there any limit on the number of consecutive Terms?

character limit: 500
What is the Board size?

character limit: 500
Are Board members compensated?
Comments: (Optional)

character limit: 500
Are any Board Members related to the Founder or CEO?
Comments: (Optional)

character limit: 500
Is there an up-to-date Board approved Strategic Plan?
*You may also upload a supporting document below.
Comments: (Optional)

character limit: 500

File Path:

IMPACT


Does your ministry survey beneficiaries about program quality and impact?
Do you measure outcomes against benchmarks?
Comments: (Optional)

character limit: 500
Do you track Key Performance Indicators?
Comments: (Optional)

character limit: 500
Do you have an Independent Impact Evaluation completed?
Comments: (Optional)

character limit: 500
Recent Program Improvement:
Briefly describe any recent improvements to your current program.

character limit: 1500

S.W.O.T. ANALYSIS


Strengths:
List your organizations strengths.

character limit: 1500
Weaknesses:
List any weaknesses of your organization.

character limit: 1500
Opportunities:
List any opportunities your organization has.

character limit: 1500
Threats:
Are there any threats to your organization?

character limit: 1500

FINANCIAL


Independent Financial Audits?
Comments:

character limit: 500
Did you receive any Government funding?
What %?

character limit: 500
Largest Gift received for your last Fiscal Year:
$

character limit: 250
Comments:

character limit: 500
HOW MANY CLIENTS SERVED?
List number of clients served in for each of the last two years and include an explanation (if needed):

character limit: 500
HOW MANY DONORS DO YOU HAVE:
List the Number of Donors for each of the last two years and include an explanation and/or Summary (if needed):

character limit: 500
INCOME: Earned Revenue
Earned Revenue Amount - List for each Fiscal Year for each of the last two years:

character limit: 500
FINANCIAL: Comments/Summary (optional)

character limit: 1500
Who completed this grant request?
Type in your Name and Date.

character limit: 250
Requested follow up date from ministry:
If selected for the Grant, what would be the optimal date for follow-up reporting? (We anticipate this would be 6-12 months after Grant is awarded).
RadDatePicker
RadDatePicker
Open the calendar popup.