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2026 Excellence In Care Grant Application

Organizations seeking funding must submit the following information, which will be scored at the percentages noted:
Organization Information (0%):
1.Contact information for the primary person in your organization who will lead the project/program for which funds are being requested(Required.)
2.List the Organization's Officers & Titles(Required.)
3.If you are a separate group within a larger organization, please provide information on how your parent organization is or is not providing support to your organization and specifically for the program request(Required.)
4.Please confirm whether your organization has received an Excellence in Care award in the past three years.(Required.)
5.Funding Category (check all that apply):(Required.)
6.Priority Population(s) (check all that apply):(Required.)
Organization Mission (10%):
7.Submit your organization’s mission statement(Required.)
8.Explain how the program aligns with your organization’s mission and program’s core client base. (500 words or less)(Required.)
9.Describe how your organization aligns with the DIFFA Chicago Mission, the goals of Get to Zero Illinois, and specifically the priority populations noted within the Get to Zero Illinois plan. (500 words or less)(Required.)
Project/Program Information (75%):
FOCUS (35%): General description of the project/program, including its specific focus on Get To Zero and whether this is an ongoing program that DIFFA Chicago has previously supported.
10.Describe the project/program and how it aligns with the Get To Zero Initiative. (500 words or less)(Required.)
11.If you have received an Excellence In Care award over the past three years, please indicate if this year’s funding request is for a new program or the continuation of the existing one. (500 words or less)
12.Include statistics on the population the program serves (i.e., the number of actual HIV/AIDS-related cases and those specifically related to service provided to one or more of our core constituencies). (500 words or less)(Required.)
13.Describe any unique elements of this program or how its implementation differs from other programs within your organization. (500 words or less)(Required.)
14.If your project/program is not entirely dedicated to HIV/AIDS, please identify the reasons why.
15.Explain why and how your program/project's focus/priority population fits within the funding category selected above. (500 words or less)(Required.)
IMPACT (30%): The impact you intend to make with the project/program and the ways in which you will evaluate the success of the project/program. Please be aware that a part of our grant process includes a request for a mid-year update on the impact our grant is making on your program.
16.Describe your project/program’s objectives and activities. (in 500 words or less)(Required.)
17.Share your expected impact/outcomes for both short and long-term goals.(Required.)
18.Explain the evaluation process your organization will use to determine the program's success. (Include the process goals, outcome goals, how you will track the planning and implementation of activities, the person/s responsible for monitoring, and how the activities and outcomes will be monitored). (in 500 words or less)(Required.)
19.If it is for an existing program, share specifics on the impact this program has made over the past year/s. (in 500 words or less)
TIMING (10%): The project/program’s timeline. Please note that this does not need to be a one-year project.
20.Provide the timeline for the project/program. (Include key deliverables, key activities, person/team/agency responsible, and target dates.) (PDF only)(Required.)
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21.If applicable, provide any pertinent past/on-going timeline data. (in 500 words or less)
22.If applicable, provide any information on how the program has changed and/or improved over time.
COST (5%): While DIFFA Chicago grants are unrestricted, we are interested in your intentions for the use of the grant.
23.How much are you requesting for this year's grant? (up to $50k)(Required.)
24.Submit a detailed budget outline matching your grant ask (up to $50k) and define specifically how the DIFFA Chicago award will be used for the project/program.(Required.)
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25.If DIFFA/Chicago cannot grant the full amount requested, how would you use partial funding or a smaller donation?(Required.)
26.How would your program's ability to provide HIV services be impacted if you were unable to receive the fully requested amount?(Required.)
Required Attachments (0%):
27.Submit a current Balance Sheet.(Required.)
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28.Submit a Profit and Loss Statement for the fiscal year-to-date.(Required.)
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29.Submit audited financial statements for the organization for the past two (2) fiscal years. (PDF only)(Required.)
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30.Submit a list of the top ten (10) funding sources and the amounts given to your organization for the previous two (2) years. (PDF only)(Required.)
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31.Submit information demonstrating the ratio of the organization’s operating expenses to direct client care. (PDF only)(Required.)
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32.Submit the organization’s IRS 501(c) (3) designation notification letter. (PDF only)(Required.)
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33.Submit the organizations W-9. (PDF only)(Required.)
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34.Submit the organization’s most recent operating budget. (PDF only)(Required.)
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35.If applicable, submit any Memorandums of Understanding if applying as a collaborative or a partnership. (PDF only)
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Interview and potential site visit (10%):
36.If your organization is being considered for one of our Excellence In Care grants, an interview and possible site visit will be scheduled with an appropriate representative/team from our organization/program. You can expect that during this interview/site visit, you will be expected to clarify questions regarding your proposal, your team’s experience, the impact of your program, and other information as needed.(Required.)
37.Marketing and Publicity Consent:(Required.)