Please submit copy via email to SDOP@chicagopresbytery.

org

Presbyterian Committee on the Self-Development of People Presbytery of Chicago 815 W Van Buren St Suite 500 Chicago, IL 60607 312-488-3005 Tel 312-488-3044 Fax sdop@chicagopresbytery.org 2013 APPLICATION FORM Deadline 5 pm Monday June 10, 2013 Instructions Send 1 electronic copy to sdop@chicagopresbytery.org by June 10, 2013. If you cannot submit your application electronically, please mail 1 hardcopy to the address above. Please review SDOP criteria BEFORE filling out this application. Print or type all information. Incomplete applications WILL NOT be processed.
I. Applicant Identification Name of the Project: _________________________________________________ Name of the Organization: _________________________________________________ (if different from Project) _________________________________________________ Address: ______________________________________________________
(if P.O. Box # please provide physical address.) ______________________________________ City: Telephone: ___________________ ___________________ State: _________ Fax: __________ Zip Code: _________________ Email: _________________

Contact Person

Name: Telephone: Fax: Email:

_________________________________ Position/Title __________________ 1) ________________________________ 2) ____________________________ 1) ________________________________ 2) ____________________________ 1) ________________________________ 2) ____________________________

Please submit copy via email to SDOP@chicagopresbytery.org II. The Proposal

a) What is the project?

b) Why is the project needed?

c) Who will benefit directly from the project?

d) Who initiated the project and how ill they be involved?

e) How did the group come together?

f)

Who owns and controls the project?

Please submit copy via email to SDOP@chicagopresbytery.org III. The Project Goal & Objectives: (In 2-3 sentences)
a) What is the project goal? (What will be different because of what the group is trying to do?)

b) How long do you expect it to take to reach the stated goal?

c) Describe the results you expect to achieve by the end of the funding period.

d) What step-by-step activities will be carried out to achieve these results?

Please submit copy via email to SDOP@chicagopresbytery.org IV.

The Evaluation/Monitoring: (in 2-3 sentences) a) How will you determine if the project is successful?

b) How will the project be evaluated?

c) Who is going to evaluate the project?

Please submit copy via email to SDOP@chicagopresbytery.org V. Decision Makers:

a) How many members are in the group?

b) How are decisions made?

c)

How does your group define poverty?

d) If decision-makers are appointed, how and by whom are they appointed? Why are they appointed rather than elected?

e) If self-selected, explain why:

f)

Are any of the decisions makers related? If so, who are they and how are they related?

g) Are the decision makers members of the group?

Please submit copy via email to SDOP@chicagopresbytery.org

h) Please list the decision-makers(majority must be below poverty level)
Name & Phone # Address (city, State & Zip Code) *No Post Office Box Job/Occupation
(How each makes a living

Poverty Level* Check one

Above Below

Indicate how chosen Check one

Appointed Elected Self- Selected

Above Below

Appointed Elected Self- Selected

Above Below

Appointed Elected Self- Selected

Above Below

Appointed Elected Self- Selected

Above Below Above Below

Appointed Elected Self- Selected

Appointed Elected Self- Selected

Above Below Above Below

Appointed Elected Self- Selected

Appointed Elected Self- Selected

Above Below

Appointed Elected Self- Selected

Above Below

Appointed Elected Self- Selected

Please submit copy via email to SDOP@chicagopresbytery.org VI. Resources (Please be specific)
a) What is the exact amount you are requesting in this application from the Local SelfDevelopment of People (SDOP)? ________________________

b) What are the resources available to support this project?

i. Physical property

ii. In-kind resources (e.g., non-monetary resources such as volunteer work, complimentary legal services, free use of office space or building, non-paid labor, donated supplies and/or equipment). List all in-kind services and/or goods that will be provided and state who will provide them and their estimated value:

iii. Financial resources from within the group

c) List all financial resources requested, promised and received from other sources (e.g. foundations, corporations, etc.) If other funds have been requested, please indicate. (This information must be provided.) Organization name and address Requested Promised Received Date Received

Please submit copy via email to SDOP@chicagopresbytery.org VII.

INCOME/EXPENDITURE BUDGET a) Staff i. Does this project have any paid staff? If yes, please list by name and describe their job functions.

ii. Who has the authority to hire and/or fire staff?

b) What is the total cost of the project? i. This year: ii. Last year: iii. Next year:

c) How will the group carry on the project financially in the future?

d.i) Has the group received SDOP funding in the past?

Check all that apply:

d.ii) Is the group currently applying for other SDOP funding? Check all that apply:

National SDOP: *Local (Synod):

Year___________ Year ___________ Year ___________

*Synod: *National

*Local (Presbytery) -

*LOCAL (SYNOD/PRESBYTERY) SDOP Committees are not in all areas.

Please submit copy via email to SDOP@chicagopresbytery.org VIII.

REQUIRED BUDGET FORMAT

Applications without a balanced budget will not be processed!! INCOME Individual Cash Donations $ __________ In-Kind Fund raising Events SDOP National SDOP Local SDOP (Synod) Local SDOP (Presbytery) List Other Sources $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________

*TOTAL INCOME

*(TOTAL INCOME MUST EQUAL TOTAL EXPENSES)

EXPENSES Itemize all expenses over $500
__________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________

National SDOP
$ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________

Local SDOP
(Synod/Presbytery)

Other
Sources

Total

$ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________ $ _____________

$ _________ $ _________ $ _________ $ _________ $ _________ $ _________ $ _________ $ _________ $ _________

$ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________

__________________________________ __________________________________ * TOTAL EXPENSES

$ __________ $ __________ $ __________

$ _____________ $ _____________ $ _____________

$ _________ $ _________ $ _________

$ __________ $ __________ $ __________

*(TOTAL INCOME MUST EQUAL TOTAL EXPENSES)

Please submit copy via email to SDOP@chicagopresbytery.org

IX.

SUPPLEMENTAL INFORMATION

A. How did the group find out about SDOP? (Please check whichever applies)

__________ Community Workshop (please indicate where and when) __________ SDOP Website __________ Local Church (please indicate the name of the church) __________ Word of mouth (please provide the name of the person) __________ Other (please be specific) B. Who completed the application? What is this persons relationship to the group?

C. While SDOP does not require the group to have the four items below, we would like to know if you have any or all of them. Please do not include copies with your application.

By-laws Tax-exempt certificate Non-profit status Articles of incorporation

Yes Yes Yes Yes

No No No No

Applied for Applied for

D. Are there any additional comments the group would like to make? (Limit to one page)

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