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* 1. Please provide the following information for your organization:

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* 2. Describe the organization's past experience successfully planning Day of Service projects or experience with other community service activities.

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* 3. Please provide the project date(s)

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* 4. Please select the grant amount you are requesting.

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* 5. Questions 5-11 will focus on project design (relating specifically to the Day of Service). Describe the identified community need(s) to be addressed and a strategy to impact them through the Day of Service project. Please provide relevant evidence of the identified community need(s). This evidence can be in the form of statistics, articles, references, or a thorough explanation of how the community need(s) relates directly to your day of service.

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* 6. Describe how community need(s) were identified. 

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* 7. Provide a brief description of the service project, including the overall objective, location, description of activities, the roles for volunteers, and number of new volunteers to be engaged.

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* 8. Describe how reflection activities will be incorporated into the service project.

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* 9. Describe how the organization will recruit and engage a diverse pool of community volunteers.

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* 10. Describe if/how the organization will partner with the other agencies or groups in the local community to assist with project development or volunteer recruitment.

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* 11. Describe the plan and process for collecting data (number of participants, number of volunteer hours, etc.) and evaluating the project.

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* 12. Question 12-16 focus on goals and outcomes of the Day of Service project.     State a desired outcome (change or benefit) for the community being served.

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* 13. State a desired outcome (change or benefit) for the engaged volunteers.

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* 14. Describe how the success of your day of service will be measured.

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* 15. Describe all data collection tools that will be used.

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* 16. Describe how the project addresses the community’s need in a sustainable way.

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* 17. Please upload the Serve Indiana Mini-Grant Budget Worksheet here. Note: Dollar-for-dollar matching is required for this mini-grant

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* 18. By checking the box below, you agree to these additional requirements of the Serve Indiana Days of Service Mini-Grant: 

a. If awarded, you will submit W-9 and Direct Deposit forms to the Department of Workforce Development within 3 business days of award notification. (This does not apply to AmeriCorps programs)

b. Having a thorough description of Day of Service activities

c. Including Serve Indiana's logo on all program materials and publicity

d. Tagging Serve Indiana in all social media posts

e. Submitting a final project report due to Serve Indiana no later than 45 days following your day of service, including a request for funds to be reimbursed, a final budget, and an agenda for your day of service.

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