HomeMy WebLinkAboutFY 25-26 Waiwai Application FINAL 11-20-2024 FY 2025-26 Application Form
The purpose of the County of Hawai'i Nonprofit Grants-in-Aid(Waiwai Grants)is to support qualified
nonprofit organizations to carry out programs or services that yield direct benefits to the public and
accomplish public purposes within the County of Hawai'i.
This grant is coordinated by the Hawai'i County Council in partnership with the Department of Finance.
A sum of at least$2.5 million is available on an annual basis through this grant program.
Applications will be accepted and can be modified/corrected until submitted to the County of
Hawai'i. The deadline for submission is 11:59 PM HST on January 31,2025. What you submit
electronically is what the County of Hawai'i will receive. Applicants are responsible for ensuring all
documents and information provided are complete and accurate before submission. Errors,missing
documents,and/or other noncompliance areas will result in your application's immediate
disqualification. We urge you to review your submission with extreme care. To resolve any technical
problems you might encounter,we encourage you to begin the application process as soon as possible.
Each organization is permitted to submit a total of two applications.Each application is limited to a
request of up to$50,000.Applications submitted through a nonprofit fiscal sponsor are not counted
towards the sponsoring organization's two limit application limit.
Any application shall be disqualified if:
• Travel funding for training/conferences is requested.
• The total score of the application is less than 70%.
• Administrative and overhead costs exceed 10%of the total application request.Administrative
costs are those incurred by grant recipients or sub-recipients in support of the day-to-day
operations of their organization.These overhead costs are the expenses that are not directly
tied to a specific program purpose.
IMPORTANT NOTICE:
Please ensure that you provide the correct email address to save your application progress before
submission. Upon saving your application progress(before submittal),you will receive an email
containing a link to take you back to your application. Do not lose or delete that email. The link that is
provided cannot be retrieved or duplicated by our system. If your application is in progress and your
link is lost,you will have to start the application process over.
For questions regarding documents required to be submitted with your application,contact:
Lisa Tada,Budget Specialist,at(808)961-8489.
For questions regarding the preparation and submission of the application or concerning the overall
grant process,contact Jessica Valdez atjessica.valdez@hawaiicounty.gov or808-961-8387.
***BEGIN NEW SECTION—"Contact Information"***
501(c)(3)Nonprofit Organization Contact Information
501(c)(3)Nonprofit Organization Contact Information
If you are applying with a fiscal sponsor,the information provided in this section should correspond to
the 501(c)(3)nonprofit organization,as they will be the legal grantee.
1. 501(c)(3)Nonprofit Organization Name(As It Appears on IRS Forms)
2. 501(c)(3)Nonprofit Organization Mailing Address
Street Address
Address Line 2
City State/Province/Region
Postal/ZIP Code Country
3. 501(c)(3)Nonprofit Organization Physical Address(if different from above)
Street Address
Address Line 2
City State/Province/Region
Postal/ZIP Code Country
501(c)(3)Nonprofit Organization Director
4. Title Suffix
First Name Last Name
Contact Person for Grant Correspondence
This person will be the primary point of contact from the 501(c)(3)Nonprofit Organization for all
communication related to this grant proposal and award.If the application is through a 501(c)(3)fiscal
sponsor,provide the contact person for the project/program.
5. Title Suffix
First Name Last Name
6. Phone Number for Contact Person for Grant Correspondence
7. Email Address for Contact Person for Grant Correspondence
8. Are you serving as a 501(c)(3)fiscal sponsor for this application?
o Yes o No
***BEGIN NEW SECTION—'Program/Service Information"**
Program/Service Information
1. Program/Service Name
2. Number of years the program/service you are applying for has been in operation.
3. If your organization is submitting two Waiwai Grant applications on behalf of its own
programs/services,please rank your proposals in order of priority for funding.(Note:
Applications submitted as a nonprofit fiscal sponsor do not count toward your organization's
two-application limit and do not need to be ranked.)
Program/Service Name
Priority#1
Priority#2
(Note for the programmer:Have#3 be optional.Do not require applicants to complete the field for
submission.)
4. For the program/service for which you are applying,do you currently have or anticipate having
any other contracts/agreements with any other department of the County of Hawai'i during
the fiscal year of this grant cycle(July 1,2025-June 30,2026)?
o Yes o No
5. If you answered"Yes"to the previous question,please tell us with what department and briefly
describe the contract/agreement deliverables.
6. Have you previously applied for and received a County Nonprofit Grant Award within the last 3
years?
o Yes o No
If"Yes",please list grant awards for the last 3 years:
FY 22-23 FY 23-24 FY 24-25
Program/Service Name
Amount of Grant Award
7. Select all areas of Hawai'i Island where the program/service will be administered,delivered,
and implemented.
❑ Puna ❑ Hamakua ❑ North Kona
❑South Hilo ❑ North Kohala ❑South Kona
❑ North Hilo ❑South Kohala ❑ Ka'u
8. If multiple boxes were checked in the previous question,please briefly describe your capacity
and plan to outreach to those geographic areas.
9. Identify the age group of the target audience(s)the program/service will serve.
❑ Infancy(0-3) ❑ Play Age(3-5) ❑School Age(6-11)
❑Adolescence(12-17)❑Young Adulthood(18-39) ❑ Middle Adulthood(40-59)
❑ Kupuna(60+)
10. Identify the primary services or activities to be provided.
❑ Educational concerns ❑Culture and the arts
❑ Needs of the poor ❑Victims of Health or Social Crises
❑Youth ❑Aged
❑Victims of Crimes ❑ Physical/Emotional Disabilities
❑ Public health and welfare of the people and the environment
In years past,applicants were asked to provide the County with an amount needed to advance their
program or service. The County receives more than 200 applications for grants-in-aid each year,
resulting in nearly every applicant getting a"slice"of what they requested and some being unable to
advance on their proposal. We recognize this grant is a small piece of your larger operation. So,
please identify a realistic amount that accurately reflects your need to carry out your program or
service. Be thoughtful in what you need as the County will make a yes/no determination on the
amount you are applying for.
11. Identify the amount of funds you are applying for. Must be equivalent to or less than your
estimated expenditures.
o $2,500 o $25,000
o $5,000 o $30,000
o $7,500 o $35,000
o $10,000 o $40,000
o $15,000 o $45,000
o $20,000 o $50,000
***BEGIN NEW SECTION—"Tracking CHANGE&Ripple Effect"***
Tracking CHANGE&Ripple Effect
CHANGE Framework Sections: Please select indicators from only ONE sector of the CHANGE
framework that best applies to the program/service you are requesting funds for(Community&
Economy,Health&Wellness,Arts&Culture,Natural Environment,Government&Civics,or
Education). Do not select indicators from more than one sector.
(Note for the programmer:Allow only one section to be selected.)
1. Does your program/service advance any of the following?
o Community&Economy Sector o Natural Environment Sector
o Health&Wellness Sector o Government&Civics Sector
o Arts&Culture Sector o Education Sector
Community&Economy Sector
Your program/service works to build a diverse and growing economy that allows people to earn
incomes and build assets while also affording opportunities for quality of life.
2. Community&Economy—Select all indicators that apply to your program/service.
❑ Diversifies economy ❑ Builds income,wealth,assets
❑Increases housing security/affordability ❑ Reduces or address the cost of living
❑ Builds community network ❑ Increases community safety
❑ Increases community capacity to adapt and/or be self-sufficient
Health&Wellness Sector
Your program/service works to provide access to care that improves the quality of life on Hawai'i Island
and keeps'ohana safe and thriving.
3. Health&Wellness- Select all indicators that apply to your program/service.
❑Addresses physician shortages ❑ Reduces healthcare costs
❑ Increases access to nutrition ❑ Provides resources for kupuna care
❑Addresses childhood poverty ❑ Provides services for at-risk youth
❑Improves access to mental/behavioral health services
Arts&Culture Sector
Your program/service cultivates Hawai'i's rich culture and arts,which enriches the social,economic,
and physical elements of community.
4. Arts&Culture-Select all indicators that apply to your program/service.
❑Supports arts education for youth ❑ Promotes Native Hawaiian Culture
❑ Provides access and opportunities to participate and practice arts and culture
❑Supports economic opportunities in the arts
Natural Environment Sector
Your program/service works to protect and preserve our natural resources and to keep Hawai'i,
Hawai'i.
5. Natural Environment-Select all indicators that apply to your program/service.
❑ Builds resilience to climate change ❑ Promotes renewable resources
❑ Reduces dependency on fossil fuels ❑ Protects water resources
❑ Promotes local food resources and security ❑ Protects biodiversity
❑ Protects watersheds and important natural environments
❑ Protects reef and ocean health
Government&Civics Sector
Your program/service works to position Hawai'i as a model for local and global civic responsibility and
collaborative policy development.
6. Government&Civics-Select all indicators that apply to your program/service.
❑ Builds community volunteerism ❑ Helps to develop community leaders
❑ Increases voter participation ❑ Increases civic engagement
❑ Promotes government transparency ❑ Builds trust in government
❑ Promotes community investment
Education Sector
Your program/service works to educate the next generation properly so we can hope to find solutions
to our most persistent and disruptive challenges.
7. Education-Select all indicators that apply to your program/service.
❑ Reduces truancy ❑ Increases earning potential
❑ Increases high school graduation rate ❑ Increases literacy
❑ Increases access to STEAM education ❑ Provides workforce development
❑ Improves access to post-secondary education
❑ Increases quality and access to early childhood education
***BEGIN NEW SECTION-'Program/Service Details"***
Please keep in mind that character counts include punctuation and spaces. Note:organizations are
required to have at least one year of experience with the proposed program/service OR can
demonstrate sufficient expertise.
1. Provide the nonprofit organization's mission statement.
2. If this application is for a program/service using a nonprofit organization as a fiscal sponsor,
provide the mission statement of the organization carrying out the program/service.
(Note for the programmer:Have#2 be optional.Do not require applicants to complete the field for
submission.)
3. In 500 characters,provide a brief narrative about your organization's experience,knowledge,
and capacity to carry out the proposed program/service.
4. In 1,000 characters,briefly describe the program/service you are seeking grant funds for.
***BEGIN NEW SECTION—"Program/Service Objectives&Performance"***
Program/Service Objectives&Performance
The next set of questions will provide grant application reviewers a clear sense of what your proposal is
designed to accomplish and what is needed to get there.Please keep in mind that character counts
include punctuation and spaces.
1. In 1,000 characters,explain the community need the program/service intends to fulfill.
Evidence(data/citations)documenting the need must be provided.
2. In bullet form,describe the ways your program/service advances the CHANGE category you
selected?(500-character limit)
Please refer to Logic Model Guide below when filling out questions 3-6.
Waiwai Grants-in-Aid Logic Model Guide
INPUTS ACTIVITIES OUTPUTS MEASUREABLE OUTCOMES
whatresourres do you need to Whot maa/or things will you do to What quantifr'able results will your Whot ore the measurable outcomes
arryoutyour ocYivitiesl achieve your outcomes. activities achieve in order to meet Jor[ire puGli�und participants bused
your outcomesl on youroctivltles7
The resources,funding,and The actions or interventions The tangible results produced The changes that will occur within
materials required to operate carried out using the inputs. through your activities. the following weeks,months or
your program. years,focusing on changes in
Should directly link to achieving Usually begins with a number and knowledge,attitudes,or
Include in-kind services, the desired outcomes. correlates with a specific activity. behaviors.
contributions.
Should be measurable and include
methods for tracking progress.
jl
3. Inputs
In bullet form,what resources do you need to carry out the activities to achieve outputs?
4. Activities
In bullet form,what major things will you do to achieve your indicators?
5. Outputs
In bullet form,what quantifiable results will your activities achieve to meet indicators?
6. Measurable Outcomes
In bullet form,what are the measurable outcomes for the public and participants based on
your activities?
7. In bullet form,describe a sustainability plan to support the proposed program/service beyond
the grant period to include:
a. One or more strategies to be implemented,
b. If any,who the sustainability partner(s)is/are(and their roles/responsibilities),
c. Any other business planning efforts to be undertaken and
d. Significant challenges and/or barriers you anticipate encountering(or are
encountering)and how the program/service will address those challenges/barriers.
***BEGIN NEW SECTION-'Program/Service Budget"***
Program/Service Budget
Complete the program/service budget,which clearly identifies how your organization will utilize the
grant funds being sought.
Program/Service Income _
CASH Anticipated Committed Total Income
$0.00 $0.00 $0.00
Other Funding Sources
(list):
$0.00 $0.00 $0.00
Add
TOTAL $0.00 $0.00 $0.00
IN-KIND Anticipated Value Committed Value Total Income
CONTRIBUTION
$0.00 $0.00 $0.00
List type of
contribution
Add
TOTAL $0.00 $0.00 $0.00
INCOME TOTAL $0.00 $0.00 $0.00
PROGRAM/SERVICE EXPENSES
A.Administrative/Overhead(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ $0.00 $0.00 $0.00
Add
TOTAL $0.00 $0.00 $0.00
B.Salary and Wages(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00 $0.00 $0.00
Add
TOTAL $0.00 $0.00 $0.00
C.Professional Fees(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00
Add
TOTAL $0.00 $0.00 $0.00
D.Operations(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00
Add
TOTAL $0.00 $0.00 $0.00
E.Supplies(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00
Add
TOTAL $0.00 $0.00 $0.00
F.Equipment(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00
Add
TOTAL $0.00 $0.00 $0.00
G.Other(list):
EXPENSE Allowable Waiwai Other Total Expense
DESCRIPTION Grant Grant Sources Expense Justification
Expense?
❑ 1 $0.00
Add
TOTAL $0.00 $0.00 $0.00
EXPENSES TOTAL: $0.00 $0.00 $0.00
*Administrative/overhead expenses are limited to 10%of the total Waiwai grant request.
***BEGIN NEW SECTION—"Forms to Review and Sign"***
Forms to Review and Sign
When uploading your file,please be sure that all fields are complete and that it is the correct and final
document.
1. Review and upload a signed copy of the Certification of Understanding.
• Complete the Agency and Program Name at the top of the form. Do not complete one
form and use it for multiple applications. Ensure that the Program Name on the
uploaded document is consistent with the program within the application.
2. Please review and upload a signed copy of the County of Hawai'i Disclosure Form.
• Complete the Agency and Program Name at the top of the form. Do not complete one
form and use it for multiple applications. Ensure that the Program Name on the
uploaded document is consistent with the program within the application.
***BEGIN NEW SECTION-"Required Organizational Documents""
Required Organizational Documents
(When uploading your files,please be sure that it is the correct and final documentj. All required
documents must be in the current organization name or supporting documents provided with the
name change(s)filed with the Department of Commerce&Consumer Affairs(DCCA).
**Note: Corporate/Board resolutions,minutes,and other documents of this nature submitted as a
requirement must indicate that the policy was adopted at a duly noticed meeting on a specified date
and be signed and certified by an authorized member of the Board.
1. Upload your Proof of Authorization(Bylaws,Resolution,etc.)for binding signature. Must be
authorized by Board to sign contracts.
2. Upload copies of your Annual Financial Statements for the two most recent years. You are
required to provide Financial Statements(Comprehensive Profit&Loss Statement,or better,
required;Audited Statements,if available)from the two most recent years. They must reflect
financial operations within the past three-year period(1/1/2022—12/31/2024). The preparer's
name,title,address,and signature must appear on the statement. If not prepared by a
licensed CPA,it must be signed by the Executive Director or authorized member of your
organization(title must be indicated,with an explanation to certify accuracy).
• A waiver may be granted to provide(a minimum of)one year's information if the
organization's date of incorporation is after January 1,2023.
• Financial statements for both years must fall completely within the three-year period.
• If your organization does not have two years of audited statements that fall within the
three-year period,it is acceptable to submit one year of audited statements and a
Comprehensive Profit&Loss Statement or better for the second year.
• If your organization does not have any audited statements within the three-year
period,it is acceptable to submit a Comprehensive Profit and Loss Statement,or
better,for both years.
3. Upload a copy of pages land 2 of your most recent IRS Form 990 filing. Provide the filing
receipt if you filed the electronic(e-Postcard)version(990N). Must be for a period ending
within the past 24 months(the filing period end date must be after January 31,2023).
• Copies marked as drafts are not acceptable. Submissions must be copies or
confirmation of documents filed with the IRS.
4. Upload a copy of your organization's IRS letter of determination verifying the agency's IRS
501(c)(3)tax-exempt status.
5. Upload a copy of your Articles of Incorporation. This must have the signature of the Executive
Director or highest-ranking member of the organization(title must be indicated,with an
explanation to certify validity). This signature may be from the initial incorporation documents
or by the current Executive in charge if these are unavailable.
0 Include all name change documents filed with the DCCA if applicable.
• Include copies of the Application for Certificate of Authority for Foreign Corporation
filed with the DCCA if applicable(a Foreign Nonprofit Corporation is a corporation not
for profit organized under laws other than Hawai'i state laws).
6. Upload a copy of your organization's current Bylaws. This must have the signature of the
Executive Director or highest-ranking member of the organization(title must be indicated,with
an explanation to certify validity). This signature may be from the initial documents of Bylaw
adoption or by the current Executive in charge if these are unavailable.
7. Upload a copy of your organization's nepotism clauses(either contained in Bylaws or
organization policies).
• The nepotism clause must be a policy prohibiting nepotism. Providing only a definition
of"Nepotism"is not acceptable.
• The document must clearly state where the policy is contained within the
organization's policies.
8. Upload a copy of your organization's conflict of interest clauses(either contained in Bylaws or
organization policies).
• The Conflict of Interest clause must apply to the Governing Board and any other
member in a position of authority.
• The Conflict of Interest clause must indicate the organization's policy on managing
potential conflicts of interest.Providing only a definition of"conflict of interest"is not
acceptable.
• The document must clearly state where the policy is contained within the
organization's policies.
***BEGIN NEW SECTION—Acknowledgements"***
Acknowledgments
1. Do you give the County permission to share information contained in your application with
other County Departments and philanthropic groups to increase possible funding opportunities
for your organization?
o Yes o No