2021 Grant Application

SECTION ONE - Eleven quick questions about you/your organization.

Question Title

* Organization Name:

Question Title

* 501(c)(3) Tax ID: (may be a fiscal sponsor)

Question Title

* Contact's Title

Question Title

* Contact's Name

Question Title

* Contact's Email Address

Question Title

* Contact's Phone

Question Title

* What is your organization's current annual operating budget?

Question Title

* If your work occurs through a smaller office, unit, or program within a larger organization, what is the annual budget of this office, unit, or program?

Question Title

* Does your organization utilize volunteers?

Question Title

* What is the race/ethnicity of your CEO/Executive Director?

Question Title

* Is your CEO/Executive Director a transgender, non-binary, or other gender diverse person?

Question Title

* Is your organization in a rural setting?

SECTION TWO: Please tell us about your Patients, Clients and or Service Users.

Question Title

* ESTIMATE the number of unduplicated LGBTQ+ Texans your organization is likely to serve over the next 90 days.

Question Title

* Estimate the percentage of your patients/clients/service users are under 18.

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are 18 – 24 year-olds.

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are transgender, non-binary, or other gender diverse people.

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are older adults (65+).

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are African-American/Black.

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are Hispanic or Latinx.

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* Estimate the percentage of your patients/clients/service users are people living with HIV?

0 100
Clear
i We adjusted the number you entered based on the slider’s scale.
SECTION THREE: Only seven more questions about your organization!

Question Title

* Under which programmatic area are you applying?

Question Title

* How does your organization or program align with the mission of Texas Pride Impact Funds? (Please limit your response to 20 lines).

Question Title

* How does your organization's mission advance racial and/or economic justice? (please limit your response to 20 lines).

Question Title

* If TPIF funds will be used to support LGBTQ+ individuals living in rural communities, please describe how you will reach this population.

Question Title

* In what specific ways does your organization's work support or address the needs of LGBTQ+  who are Black, Indigenous, and People of Color (BIPOC). Please identify which BIPOC communities your organization serves and the strategies your organization uses to advance systemic changes to support these communities (please limit your response to 20 lines).

Question Title

* If you were to receive a grant from the Texas Pride Impact Funds, how would your organization use the funds?  (Please limit your response to 20 lines).

Question Title

* Is there anything else you’d like to share with us about your organization’s and communities' current situation or anticipated future? (Please limit your response to 20 lines).

Thank you for completing your Texas Pride Impact Funds 2021 Grant Cycle Application. 

T