SEPA Nonprofit Organization ApplicationUpdated on: January 15, 2017 Austin College is currently accepting applications from local non‐profit organizations to participate in the 2017 Social Entrepreneurship for Poverty Alleviation (SEPA) Program. The program is designed to increase Austin College student engagement in the local community, increase collaboration with local NPOs, and provide grant writing training and internships for the students and agencies. Participating students and local NPOs first participate in a two‐day grant writing workshop hosted by Austin College, June 1-2, 2017. Participating students are then assigned to work with a partnering NPO for the summer and help the agency source and apply for grants. The program provides local nonprofits with grant‐writing training, as well as staffing assistance with energetic and intelligent Austin College students facilitating collaboration to address important local social and economic issues, and finally, providing those Austin College students with outstanding learning opportunities. The cost of the workshop and the student internships are covered by Austin College. To apply for the program please provide the following information by March 31, 2017. Agency NamePrimary ContactEmail PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Year FoundedPlease provide a description of the agency’s mission and responsibilities:What geographic region does the agency serve?How many people does the agency serve?Indicate a specific program or project you will focus on during the workshop and the summer internship. (We find the program works better if the agency has a specific project or grant in mind.)Please respond to the following questions related to your grant readiness.Do you have the following materials? (Not having all of these materials will not exclude you from the program, but we like to assess the position of the organizations):1) Business/Organizational Charter or your State official Incorporation Documentation ‐ (Through your state Secretary's Office)YesNo2) A Federal Tax Identification Number (EIN)YesNoThird Choice3) IRS Federal Exemption Organization (EO) 501c3 determination letterYesNo4) Governance Structure (Organizational Chart or other description)YesNo5) Board Roster (List of Board Members with Contact info)YesNo6) Organizational Bylaws (currently updated)YesNo7) Key Staff Roster (Paid or Volunteer)YesNo8) Mission & Vision StatementsYesNo9) Strategic Plan (Organizational and Programmatic goals and objectives)YesNo10) Organizational annual budget (a budget of actual and projected annual revenues and expenses)YesNo11) Employee Policies and ProceduresYesNo12) Volunteer Policies and ProceduresYesNo13) Financial Statements for Prior 2‐3 years ‐ if applicable (i.e. 990 tax returns, profit and loss statements, bank statements, etc.)YesNo14) Fiscal Policies and ProceduresYesNo15) Organizational and Programmatic Descriptions (for every program and service offered or proposed)YesNo16) Community Relations/Strategic Partnerships (identified by agency/org, time‐frame of relationship and type of commitment)YesNo17) Audited Financial Statements (financial statements for budgets below $300,000 annually)YesNo18) List of current and previously funded grants (if applicable)YesNo19) Grants Management Processes and Controls (Current and/or Future)YesNo20) Key Staff Structure as it relates to the grants you are seeking (Names, Titles, Reporting Structure, and Brief Bios)YesNo21) Key Administrative Info (resumes, bios, and job descriptions)YesNo22) Key Program Staff Info (resumes, bios, and job descriptions)YesNo23) A list of any and all consultants (that will work with the proposed program or project)YesNoPlease confirm that you agree to the following conditions of the program by checking the boxes next to the statements:* I confirm that a representative of my agency or I will attend the grant writing workshop in Summer 2017. Dates are TBD at this time. I confirm that I am willing to supervise the student and to provide them with adequate hands‐on opportunities to work in project development, research, and grant writing. I agree to participate in a post‐program survey and discussion forum to help us evaluate the program. Please upload a copy of the agency’s 501c3 letter.