Spring 2022 ASSET Program Application

Please complete your application in a word processing editor (such as Microsoft Word) before transferring answers to the online application. You cannot save and return to the online application, and you will not receive a copy of your online submission. If you prefer, you can email a PDF or Word document of your completed application to mariah.byrne@stl.unitedway.org. The application is due Friday, February 18, 2022 by 5:00 pm. Thank you!

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* 1. Organization Information:

Organization Name:

Federal Tax ID Number:

Headquarter Address:

City, State, Zip Code:

Address where program will be delivered (or indicate online):

City, State, Zip Code:

Website URL:

Executive Director/CEO Name:

Executive Director/CEO Email:

Executive Director/CEO Phone:

Primary Contact Name (if different):

Primary Contact Title:

Primary Contact Email:

Primary Contact Phone:

Year of Incorporation:

Accreditation Body (if applicable):

Total Agency Budget:

Total Requested Amount:

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* 2. Briefly describe your agency’s mission, vision, values, and how this program fits with your strategic goals.

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* 3. How many participants do you intend to enroll in the program? (United Way encourages you to over-enroll participants as it is unlikely all will complete classes.)

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* 4. Based on the number of participants you anticipate will complete the financial education portion of the program, what grant amount are you requesting?

You can use the following formula to determine the amount you are requesting:

# of participants who complete financial education x $250 = $ (total amount of request, max $5,000)

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* 5. The ASSET program is meant to primarily target parents/caregivers who have minor children. Please describe the demographics of the population you plan to serve through this program.

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* 6. Will you be offering the financial education classes:

Online only, live

Online only, recorded or using self-paced FDIC curriculum modules

In-person only

Online and in-person (please describe)

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* 7. (Optional) In addition to class participants, up to 5 front-line (non-managerial) staff members may participate in the program. (The organization will not receive grant money for staff members.) How many staff members do you anticipate enrolling, and what are their roles in the agency?

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* 8. Please provide the name(s) and address(es) of the proposed program site(s) and the projected number of participants who will be served at each site (if applicable.)

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* 9. How will you market the ASSET program and recruit participants?

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* 10. If you plan to offer live or recorded classes, who will teach your financial education classes? Please note if you will need assistance locating financial education instructors.

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* 11. Do you already provide budgeting and credit counseling to agency participants? If so, who provides the counseling services (Justine Petersen, Prosperity Connection, Community Action Agency, MMI, organization staff, or other)?

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* 12. How will your organization provide support, including reminders and follow-up, to participants throughout the program?

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* 13. You will need to select one staff member to be the ASSET program manager—overseeing participant paperwork, data management, and tracking attendance—for your organization. Provide the credentials and competencies of the staff who will be responsible for managing the program (i.e. resume or paragraph describing applicable background and experience). If the person has not yet been hired, please provide job description.

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* 14. What will the grant funds be used for? Complete the budget template below

Technology

Childcare

Food

Transportation

Staff Support

Participant Incentives

Other

Grant Total (max $5,000)

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* 15. Please give a detailed description for how you plan to use the funds (staff support, food, transportation, childcare, financial education materials, technology needs such as hotspots, tablets, etc.). Program funds are intended to cover staff time and to assist participants in overcoming obstacles to participation.

Organizations that are not funded by United Way must email the following documentation to Financial Stability Initiatives Program Manager Mariah Byrne, mariah.byrne@stl.unitedway.org, in order to complete the application.

Federal 501(c)(3) Tax Determination Letter
Illinois or Missouri Certificate of Corporate Good Standing
Agency policy for background checks, including child abuse and neglect screenings
Board of Directors Roster
Most recent Audited Financial Statements including auditor’s opinion and footnotes*
Most recent Management Letter prepared by independent auditor*

*In place of these documents, agencies with total annual budgets under $300,000 may instead supply unaudited financial statements that include both a balance sheet and an income statement for their last two fiscal years.