Central Indiana Racial Equity Fund

Organization Information

Organization Name *

Fiscal Sponsor Organization (if applicable)

Organization and/or Fiscal Agent EIN *

(E.x. 31-1234567)

President/CEO of Organization *

Annual Organization Budget *

$

Applicant First Name *

Applicant Last Name *

Applicant Title *

Applicant Email Address *

Program Lead *

Board of Director Demographics

What is the size of your board of directors? *

Please indicate how many of your board members identify as the following:

Asian

African-American

African Diaspora

Hispanic/Latinx

Middle Eastern/North African

Native Hawaiian/Pacific Islander

White

Female/Women

Male/Men

TransFemale/TransWoman

TransMale/TransMan

Non-Binary

Application Summary

Project Title *

Project Description (100 word limit) *

Amount Requested *

$

Total Project Budget *

$

Project Begin Date *

Project End Date *

Type of Funding Requested *

Operating

Programming

Capacity Building

OtherOther

Community Impact

Total Number of People Served *

Please indicate how many of the people you are serving identify as the following:

Asian

African-American

African Diaspora

Hispanic or Latinx

Middle Eastern or North African

Native Hawaiian or Other Pacific Islander

White

With a focus specific to the African-American population, please indicate how many of the people you are serving identify as the following:

African-American Boys

African-American Men

African-American Girls

African-American Women

African Diaspora

With a focus specific to these special populations, please indicate how many of the people you are serving identify as the following:

Incarcerated/Formerly Incarcerated People

Opportunity Youth (ages 18-24)

Immigrants

Justice Involved Youth

Differently-Abled People

LGBTQ+

Seniors (55+)

Please describe the population you are working with or on behalf of in this grant request: What challenges or barriers do they face in achieving racial and economic equity? (limited to 250 words) *

Proposal Narrative - Organizational History & Commitment

Which CIREF priority best aligns with your organization’s history of commitment to racial equity? *

1. Improving and reducing interactions between the African American community and Central Indiana law enforcement departments and agencies

2. Reducing African American representation in the juvenile and criminal justice system by providing positive alternatives for education and employment

3. Increasing employment and wealth opportunity for African American communities, in particular, as it relates to matters of criminal justice, re-entry, and police interactions

What have been your organization’s most significant contributions to advancing racial equity in the CIREF priorities areas? (limited to 250 words) *

How does your organization work with and learn from people who have been systemically oppressed and/or excluded? (limited to 250 words) *

Proposal Narrative - Project Details

Describe the community need that your project addresses. (limited to 250 words) *

Describe how your project addresses this need and impact the community (limited to 500 words) *

Describe, in your own words, the innovation behind your approach (limited to 250 words) *

Describe what partners, if any, will be leveraged and how with this project. (limited to 250 words) *

Describe how you will measure and/or evaluate your project’s effect. (limited to 250 words) *

How does your project contribute to racial equity within CIREF priority areas? (limited to 250 words) *

Describe your plan to sustain this project beyond CIREF resources. (limited to 250 words) *

Measurable Outcomes

Please fill in the measurement outcome fields below.

Proposed Measurable Outcome #1 *

Measurement Method #1 *

Estimated Number to be Served #1 *

Proposed Measurable Outcome #2 *

Measurement Method #2 *

Estimated Number to be Served #2 *

Proposed Measurable Outcome #3 *

Measurement Method #3 *

Estimated Number to be Served #3 *

Resident Engagement

Briefly describe how long you have been engaged with residents in this work. (limited to 100 words) *

Please describe how the feedback of your constituency informs your program design and implementation? (limited to 250 words) *

Please include the names and contact information for two residents that will benefit from this request. These residents should be unaffiliated with the governance and finances of the organization.

Resident Name #1 *

Phone Number *

Email Address *

Resident Name #2 *

Phone Number *

Email Address *

Budgetary Information - Project Income

Please complete the fields below to indicate how funds will be used in support of this project.

Service Fees & Admissions - Amount

$

Service Fees & Admissions - In-Kind

Corporate Contributions and Sponsorship - Amount

$

Corporate Contributions and Sponsorship - In-Kind

Individual Contributions - Amount

$

Individual Contributions - In-Kind

Foundation Support - Amount

$

Foundation Support - In-Kind

Fundraisers & Special Events - Amount

$

Fundraisers & Special Events - In-Kind

Government Support (city, state, federal) - Amount

$

Government Support (city, state, federal) - In-Kind

Internal Reallocation - Amount

$

Internal Reallocation - In-Kind

CIREF Support - Amount

$

CIREF Support - In-Kind

Other - Amount

$

Other - In-Kind

Budgetary Information - Project Expenses

Please complete the fields below to indicate how funds will be used in support of this project.

Employee Compensation, Benefits & Taxes - Amount

$

Employee Compensation, Benefits & Taxes - In-Kind

Professional Fees & Contracted Labor - Amount

$

Professional Fees & Contracted Labor - In-Kind

Professional Development - Amount

$

Professional Development - In-Kind

Printing & Publication- Amount

$

Printing & Publication- In-Kind

Supplies - Amount

$

Supplies - In-Kind

Marketing & Advertising - Amount

$

Marketing & Advertising - In-Kind

Space Rental & Occupancy - Amount

$

Space Rental & Occupancy - In-Kind

Travel & Transportation - Amount

$

Travel & Transportation - In-Kind

Other - Amount

$

Other - In-Kind

Budgetary Information - CIREF Expenses

Please complete the fields below to indicate how CIREF funds will be used in support of this project.

Employee Compensation, Benefits & Taxes - Amount

$

Employee Compensation, Benefits & Taxes - In-Kind

Professional Fees & Contracted Labor - Amount

$

Professional Fees & Contracted Labor - In-Kind

Professional Development - Amount

$

Professional Development - In-Kind

Printing & Publication- Amount

$

Printing & Publication- In-Kind

Supplies - Amount

$

Supplies - In-Kind

Marketing & Advertising - Amount

$

Marketing & Advertising - In-Kind

Space Rental & Occupancy - Amount

$

Space Rental & Occupancy - In-Kind

Travel & Transportation - Amount

$

Travel & Transportation - In-Kind

Other - Amount

$

Other - In-Kind

CIREF Community of Practice

The CIREF Steering Committee is considering the creation of a community of practice to increase collaboration, enhance learning, and develop innovative approaches to increasing racial equity specific to the criminal justice system and those it disproportionately impacts in our region. If this community of practice were to be established, would your organization be interested in participating (likely on a monthly basis)? *

Yes

No

What might you hope to accomplish as a result of your participation?

Additional Documentation Needed

Alongside of this request, please submit the following documents:

Your organization’s most current board list
Your most current 990
Your most current financial audit and/or financial compilation
Any letters of support drafted by residents, stakeholders, or community partners that you would like to provide (limit of two)

*

Maximum file size: 268.44MB

Applications for the responsive round are due by Oct. 30 at noon.

Organization Information

Board of Director Demographics

Application Summary

Community Impact

Proposal Narrative - Organizational History & Commitment

Proposal Narrative - Project Details

Measurable Outcomes

Resident Engagement

Budgetary Information - Project Income

Budgetary Information - Project Expenses

Budgetary Information - CIREF Expenses

CIREF Community of Practice

Additional Documentation Needed

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