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Instructions:  The application should consist of a cover letter, summary, and attachments.

I. Summary

Include a cover letter (one page) on letterhead that contains the following summary information:

1. Briefly explain the History and Mission of your organization.

2. Explain how your organization’s proposal fits with the Chartwell Foundation mission.

3. Provide the contact person’s name, title, daytime telephone number, E-mail address, and fax number. The letter must be signed by the board president and executive director or CEO.

II. Proposal Narrative

Two pages Maximum

A. Purpose of Request and Anticipated Results

1. State the issue, need or program to be addressed, along with expected results, who will benefit and how. 

2. For general support requests, describe how the request will enhance organizational capacity, sustainability and/or the achievement of measurable results for the organization.

a) For general operating support requests, please describe how your organizational assesses its overall success.

B. Organizational Capacity

1. Describe the organization’s ability to implement the request or explain the organizational limitations that funding will address.

a) Explain how this proposal relates to the organization’s mission, goals, and/or strategic plan, and other activities planned for this year.

b) Describe the organization’s current programs and activities, track record, related program or organizational accomplishments, accreditation, awards, or other strengths.

III. Attachments

The following attachments are required:

A. Finances

1. Financial statement from the most recently completed year, audited if available. Provide a copy of the organization’s most recent IRS Form 990 tax return if audited financials are not available.

2. Organization budget for current year, including income and expenses.

B. Board of Directors

1. List the board members and affiliations.  Describe the board’s financial support of the organization (percent contributing) for the most recently completed fiscal year.

C. Other

1. A copy of the organization’s current IRS determination letter (or the fiscal agent’s) indicating 501(c)(3) tax-exempt status.

2. A copy of the organization’s registration with the Charitable Organization Division of the Office of the Secretary of State for the State of Maryland, or indicate the reason for exemption.

3. Copy of the organization’s most recent annual report (if available).