2024 Grant Application Eligibility Form

Thank you for your interest in our 2024 Grant Application. To determine your eligibility to receive the Grant Application, please submit this Application Eligibility Form no later than July 8, 2024. An automatic acknowledgment of your submission will be forwarded to you from the Action-Impact100 SRQ email address. If you do not receive it, please check your spam folder.

If your eligibility to receive the Grant Application is confirmed, you will receive an email with the link to the Application. The Grant Application will be available starting on April 17, 2024. If your eligibility is confirmed before April 17, 2024, you will be notified of your confirmation but you will not receive the link to the Application until that date. On April 16, 2024, we will announce our 2024 Giving Year membership numbers which will determine how many Grants we will award and each Grant’s dollar amount. The last day to submit the Grant Application is July 17, 2024 at 12 NOON Eastern Standard Time.

Please note that only eligibility to submit an application will be confirmed through the information provided, and submission of this Application Eligibility Form does not guarantee eligibility or funding.

First Name *

Last Name *

Email *

Contact Information

Legal Name of Organization

Contact Name

Contact Title

Contact Email

Contact Best Phone Number

Phone Number Type

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Address (Street, City, State and Zip Code)

Application Eligibility Questions

If you answer "NO" to any of the application eligibility questions, you may or may not be eligible to apply for this Grant. We will review the information you provide. If your eligibility is confirmed, you will receive a link to the Grant Application starting April 17, 2024.

Is your organization a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code? If “No”, does your organization have an application for 501(c)(3) status pending approval by the IRS?

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Please enter the EIN as stated on the IRS Department of the Treasury letter classifying your organization as a public charity.

Is your organization registered with the Florida Division of Corporations as a nonprofit organization (as reflected by your current Annual Report being filed and available on the Florida Sunbiz website)?

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Is your organization registered with the Florida Department of Agriculture and Consumer Services (required of all charities soliciting in Florida, excluding religious, education and government entities)?

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Please provide your FDACS Charity Number.

Has your organization been in operation for a minimum of 24 months and able to provide Financial Statements and Tax Returns for that period?

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Is your organization free of legal actions declared, including current and pending conflicts?

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If you answered “No” to the question "Is your organization free of legal actions declared, including current and pending conflicts?", please explain why you answered “No”.

Will the Initiative you seek funding for primarily serve and benefit the communities and residents of Sarasota and/or Manatee Counties?

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Is the Initiative you are seeking funding for a new project, program, or capital expense or a significant, clearly defined expansion of an existing project, program, or capital expense? An expansion must be clearly defined by a significant increase in the population served, a broadening of the offering to a different population category or a broadening of the type of service offering. For an expansion, only the direct operating expenses that support the expansion will be funded. A continuation of an existing program or service offering is not eligible for an Impact100 SRQ grant.

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Will you expend the full amount of the requested grant funds within the 24-month grant period that begins on the January 2025 award date?

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If your Initiative is a capital improvement or renovation to property, do you own the property or have a written property lease or other valid written agreement that you can provide that demonstrates the permission of the property owner to fully implement the Initiative?

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Please let us know in which Focus Area you intend to apply. Please keep in mind that your Initiative should align with your choice of Focus Area.

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Impact100 SRQ will not provide grants for:

General operating expenses that support the organization's current operations and programs, overhead expenses or expenses that are based on a cost allocation. Only the direct operating expenses that support the new or expanded initiative will be funded by Impact100 SRQ. Detailed allocation of funds is required.
Ongoing salaries for existing staff that support the organization's current operations and programs. For initiatives with expenses for existing staff, the organization must demonstrate these expenses are solely in support of the initiative by stating whether the hours and salary of the existing staff will increase or whether the existing staff's current responsibilities will be assigned to others.
Debt reduction, operational deficits, interim funding, bridge funding or endowment funding
Grants to individuals
Any type of arrangement whereby our grant funds are held temporarily, including arrangements whereby the funds are transferred, either partially or in their entirely, to any other person or entity for its use/benefit or any other person or entity not described in the Grant Application
Partisan, legislative or political activity
Initiatives of individual religious institutions will not be funded unless it is a separate tax-exempt entity that is not under the umbrella of the religious institution and exists for receiving Impact100 SRQ funds
Initiatives not available to any person, regardless of religious beliefs or practices or any person being required to participate in any religious activity, ceremony, or service
Capital improvements or renovations to property if the organization does not own the property or provide a written property lease or other valid written agreement that demonstrates the permission of the property owner to fully implement the initiative
Grant recipients of an Impact100 SRQ grant awarded in the last two grant cycles

Please confirm that you will be able to verify and provide supporting proof of above, if applicable, during the grant application review process.

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Verification

I confirm that, to the best of my knowledge, all responses are accurate and have been approved by our organization's Executive Director or Board Chair.

Please note that only eligibility to submit an application is confirmed through the information provided, and submission of this Application Eligibility Form does not guarantee eligibility or funding.

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Impact100 SRQ reserves the right to change its Grant Eligibility Guidelines without notice at any time.