SCBA Grant Application

1. Organization Information

Organization Name:

Mailing Address:

Website (if applicable):

Primary Contact Name & Title:

Email Address:

Phone Number:

Organization’s Mission Statement:

Is your organization a registered 501(c)(3)?

YesNo

If no, please explain your organization’s nonprofit status:

2. Program Information

Program Name:

Amount of Funding Requested:

Program Start and End Dates:

Briefly describe the program or initiative for which you are seeking funding. (500 words max)

How does this program align with SCBA’s mission to empower youth in the South Coast through scholarships, program funding, or career development?

What specific population of youth will this program serve? (Check all that apply):

Elementary School (ages 5–10)Middle School (ages 11–13)High School (ages 14–18)Young Adults (ages 19–24)Other

How many youth do you anticipate serving with this funding?

3. Program Impact & Outcomes

What key outcomes do you hope to achieve with this funding? (Check all that apply):

Increased access to educational resourcesImproved academic performanceCareer readiness & workforce trainingIncreased mentorship opportunitiesEnhanced social and emotional well-beingOther

What measurable indicators will you use to track program success?

Do you have a plan for sustaining this program beyond SCBA’s funding? If so, please explain.

4. Budget & Funding Details

Total Program Budget:

Funding Breakdown:

Staffing:

Program Materials/Supplies:

Transportation:

Scholarships/Direct Support:

Other (please specify):

Have you received SCBA funding in the past?

YesNo

If yes, please briefly describe how previous funding was used and any outcomes achieved:

What other sources of funding are supporting this program? (Check all that apply):

Private DonationsGovernment GrantsCorporate SponsorshipsOther Nonprofit GrantsOther

5. Additional Information

Are there any challenges or barriers your organization faces in serving youth that SCBA should be aware of?

How does your organization measure and report on the impact of its programs?

Is there any other information you would like to share about your organization or program?

6. Signature & Agreement

I certify that the information provided in this application is accurate and that the funds requested will be used solely for the purposes outlined above.

Signature (Typed Name):

Title:

Date:

Δ