HomeMy WebLinkAboutAttch 2e Dublin Partners in EducationI!
ITY OF UBLIN
COMMUNITY GROUP/ORGANIZATIONAL
FUNDING REQUEST
APPLICATION PACKET
Fiscal Year 2010-2011
Section Z o
Application for
Cornmunity Group/Organizational Funding
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CITY OF DUBLIN
Fiscal Year ZO10-2011
COMMUNITY GROUP/ORGANIZATION
APPLICATION FOR FUNDS
COVER PAGE
AGENCY NAME: DUBLIN PARTNERS IN EDUCATION
PROPOSED PROJECT/PROGRAM NAME:
OPERATIONAL EXPENSES FOR VOCATIONAL
MENTORING, PROMOTION OF THE ARTS PROGRAM, AND
CAREER
DAYS
FUNDING AMOUNT REQUESTED:
$15,000.00
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CITY OF I)UBLIN
Fiscal Year 2010-2011
APPLICATION FOR FUNDS
i.
Please select one expense category: ^ Capital X Operating
2. Applicant Information:
Organization/Agency Name _Dublin Partners in Education
Mailing Address_ P O
Box2307
Street Address 6800 Penn Drive
City Dublin
Zip_94568
_Janet Lockhart.
State Ca
LockhartJanet(~a,dublin.k 12.ca.us
Executive Director/Chairperson Work Phone
925 828-2551x5431
Board President (if applicable) Work Phone
Email
Please list the Primary Project Contact Person who would be able to answer questions about this application and
project/program during the funding period.
Janet Lockhart Executive
Director
Email
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Contact Person for Project/Program Job Title
925 828-2551x5431
Work Phone Email Fax
Federal Tax Identification No. (required) _94-
3207780
City of Dublin Business License No. (required) _10048
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City of Dublin
Fiscal Year 2010-2011
Applicatio~a for Fund~
3. Proposed Project/Program Information (Do not describe organization.)
Amount of Funds Requested $ ~15,000.00
(Maximum $25,000 per project.)
Proposed Project/Program Name:
_Operational Expenses for Vocational Mentoring, Promotions of the Arts program, and
Career Days
Proposed Project/Program Date(s): Start _7_ /_1_ / 10_ and End _6/30_ / 11_
mo. day yr. - mo. day yr.
Please note: City Council Grant Funds are distributed on a reimbursement basis. If your Agency
needs a 100% disbursement at the beginning of the Fiscal Year, please indicate this
below and provide justification for this need.
XX^ Agency is requesting 100% disbursement at the beginning of the Fiscal Year.
If selecting this option, please provide justification in the blank space below.
^ Agency is not requesting 100% disbursement at the beginning of the Fiscal Year.
Please provide the frequency that reimbursements will be submitted to the City in the
blank space below; e.g., monthly, quarterly, at project completion, etc.
XX : DPIE sets a budget annually applicable July 1 through June 30. A 100% disbursement
allows us to create a work plan for the entire school year. Receiving funds at the beginning of
the fiscal year allows us to ensure that our programs can continue while we work to write grants,
plan fundraising events, and collaborate with our business partners to bring much needed
funding to our schools.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
a. How would the requested funds be used?
b.
^ Describe, in detail, the PROPOSED PROJECT/PROGRAM (not the Agency).
^ Bulleted text is acceptable.
^ Identify if the proposed project/program is a new service, or extension of an
existing one.
^ An additional page may be added, if needed.
** Career Days: Local business and community volunteers spend a full day with students,
sharing valuable career information and personal professional experiences with Fallon and
Wells 8~' graders; helping them see all the future possibilities that education can create for
them. Mentors experience the enthusiasm of our young people who are anxious to hear what
the future might bring.
**Mentor Program: Dublin and Ualley High School students attend a series of
presentations given by local business and community volunteers who share their career
knowledge and professional experiences, offering a window into the world of work. Mentors
share their own career paths, the wisdom they ~ave gleaned from their experiences and some
of the values that have helped them become successful at what they do. This program
includes approximately 1,600 students. Not only does it support our students as they
prepare for vocational school, the military, or higher education, but mentors experience the
satisfaction of sharing their own lives with students and often come away from the
experience refreshed and more enthusiastic about what they do. This prograrn is a wonderful
example of collaboration and community spirit; joining business and education in a way that
supports both.
** Promotion of the Arts: One cannot fully appreciate the value and scope of this program
without attending the annual Art Judging and the Art Awards Night. This program links
volunteer guest artists in our communiTy with classrooms; engaging the spirit of each artist
and creating enthusiasm for art in education. Our young artists in the schools are encouraged
to explore their own creativity by teaming with these wonderful volunteers for whom art is a
passion and in some cases a profession. Student art is submitted for the annual art juding.
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These .students are then celebrated at the Art Awards Night where they receive recognition
and encouragement for self expression. Not only are the students benefiting from this
program, but the volunteers who work with the students, the judges that participate in the
program, and the business community and residents who purchase the art all become a
successful and integral part of the program. This year's Art in the Schools program will grow
with the addition of a Photography category for grades 1-12 and a videography category for
grades 9-12. Each of these categories will ask the question," What do you like about
Dublin"? Students will be encouraged to submit a photograph expressing their opinion or a
30 second video inarketing their "likes." This Art in the Schools program will serve more
than 5,600 young people in our community.
**Dictionary Give-Away: For the second year DPIE will partner with the Dublin Rotary
Club to fund the purchase and distribution of brand new dictionaries to every third grade
student in the Dublin School District. This has proven to be a great partnership and
invaluable opportunity not only for third grade students but their families as well. Many
students have reported that this is the first dictionary in their home.
c. How would the PROPOSED PROJECT/PROGRAM address an unmet community
need and improve the quality of life for Dublin residents. Why is this project/program
needed? (Additional page may be added, if needed):
Now, more than ever, the quality of education desired by residents of Dublin far
exceeds the very basic education funded by the State. DPIE seeks to help the Dublin
Unified School District bridge the gap between what the State provides in terms of
funding and what is needed to fund the type and quality of programs offered to our
students.
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d. What documentation/data/records support the need for this PROPOSED
PROJECT/PROGRAM? Please identify your data sources. (Additional page may be
added, if needed.)
With the grant funding we have requested, DPIE's programs will provide enriched learning opportunities,
and clearly ones that will not be funded any other way. Our Partnership activities are like other educational
foundation in surrounding areas and nationally. It has been demonstrated that Partnership programs
positively impact students and schools in these areas: Academic achievements, Schooi attendance, Career
planning, Student enrichment, Self-image, and School Pride.
(source: www.partnerstoledo.or~partnership.html)
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City of Dublin
Fiscal Year 2010-2011
Application foY Funds
d. Specify the PROPOSED PROJECT/PROGRAM population to be served.
Dublin students in the Dublin Unified School District, K-12, and Adult Education will be
the primary beneficiaries of the programs we are requesting funding for. However, we also
strongly believe that Community volunteers and Business professionals who seek to contribute to
the Dublin community through tlie spirit of DPIE partnerships and collaborations will also
strongly benefit f~m these programs.
e. Projects/prograins must be evaluated to determine if they are being carried out efficiently
and if project/program goals are_being met. Please describe how you plan to monitor
your project/program's success and impact.
^ An additional page may be added, if needed:
The monitoring of programs is an ongoing process for DPIE. Our Board of Directors,
represented by sub-committees, work on each program along with staff. Each program is
thoroughly reviewed by staff and board at the planning stages as well as at the completion of the
program.
f. Specify numbers of clients served by agency, then by PROPOSED
• PROJECT/PROGRAM:
The number of students served varies depending on the program. Our overall programming is
designed to provide something for every student in the district. Many parents and members of
our business communitv are also included.
..; ..
~ A eric~ ~,Partici ant' Information ;; 4, z`` ;.
o~ ~~ _ . _ ~ _. . _ .,~ . . :_ ~ .a P ~~
~~. ~ ~~ .: .~. ., _~,.
Total Number of Partici ants Served by Agency (if a licable) 5,967 students..
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Total Number of Dublin Residents Served by Agency (if applicable) 5, 967 students
plus parents,
volunteers and
Partners (est.
additiona1200
residents and
business artners.
°Pro ect/Pro ram Partici ant °Informationx ~ ~
Total Pro osed Partici ants Served by this Project/Program 6,167 articipants
Total Number of Dublin Residents Served by this Project 6, 267 Dublin
residents
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City of Dublin
Fiscal Year 2010-2011
Application f'or Funds
5. Financial Information - Operating Budget.
a. Expense Budget
. ` FY 201,0 2011 ~ 'Txls. PRO~cT/ . ~ . - ..
,~. . _ ~ a~ N ~,~ , o ~. ~ ..-:~ ~ ~ " - - ~ - ~
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° EXPENSE BUDGET - ~ - ' ORGANTZATION ' ° PROGRAM ~ GRANT REQUEST'
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Personnel Costs ` ~- ° d ~ ~ ~ d ~ ~' °
~~~v. .~..~,},~, . K„ ... ,.. „ -:
Employee Salaries & Benefits $0,600
Non Personnel Co"sts ` y ~
Taxes and Fees 500
Capital Costs -
Other Marketing/program info 5,500
Other Professional Develop. 1,000
TOTAL 86,600
Further Comments/Explanations (if necessary):
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City of Dublin
Fiscal Year 2010-2011
~4pplication for Funds
b. Revenue Budget
FY' 2010 201;1 ~ ~ ~ .
~ . ~ s~ _ ,~ ,. ;; - ,. ~ .
_ ~x , ., .. . , -... ..
, ,REVENUE_:•BiTDGET -_ ORGANIZATION _ PROJECT/PROGRAM
Comriiitted/R'estricted~Funds ~ , ' ~ ?
(speci 'source) ~' - ~ ~ ~~`~ `~
Misc. Grants 15,000
Citv of Dublin 15,000
.. _ ~
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,
.. . _ .
Noa Cammitted/Restric`ted °FundsG ~ ~
~ ~
r
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..,r.y .N~] '~'<'
(specify source) ~
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Student Art Auction 34,000
Fireworks Sales 12,000
Dinner Partners in Education 45,000
Membershi 20,000
BowI-A-Rama 5,000
Summer Bowling Program 300
TOTAL 146,300
Further CommentslExplanations (if necessary):
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City of Dublin
Fiscal Year 2010-2011
Appdicatio~ for Funds
6. General Agency Information
XX^ Past grant applicants may check this box in lieu of completing item 6(a-d) if the
program/organizational description on file with the City is correct and current.
a. List all years that Organization has previously received City of Dublin funding (not
Community Development Block Grant - CDBG).
b. Describe the population(s) served by the Organization.
c. Describe all the services the Organization currently provides to Dublin residents.
^ An additional page may be added, if needed.
d. Has your agency ever previously received funds from the City of Dublin? If yes,
please specify in what Fiscal Years and the amount received each year.
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City of Dublin
Fiscal Year 2010-2011
Application for ~'unds
7. Required Attachments:
o Onlv one (1) copv aer AEencv of each of the following is required, even with multiple
projects/programs submitted.
o Applications without the foliowing documents will not be reviewed for funding.
o Please label attachments: A, B, C, etc.
X A. , Names of Governing Board; identify current Board officers.
X B. Current total Organization o~erating budget, including revenue.
^ Clearly label/identify the program that includes the pROPOSED
PROJECT/PROGRAM.
X C. Most recent audit report or tax return (if applicable).
X D. Resolution, letter or other document providing evidence of
X E. Board/Organization approval of application, and date approval was
granted. Board/Organization approval may be pending.
X E. Organization's certificate of insurance showing coverage for liability and
workers' compensation.
X F. Application Verification Declaration Signature Page.
X G. Signed affidavit form from each collaborating agency named in proposed
project/program plan (if applicable).
X H. Copy of IRS Letter of Determination indicating tax exempt status.
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City of Dublin
Fiscal Year 2010-2011
Application for Funds
APPLICATION VERIFICATION
I attest that the information contained in this FY 2010-2011 grant application is accurate and that
the funds requested will not supplant any other monies secured by the organization.
Attached is a resolution, letter, or other document providing evidence that the Board of Directors
approved the application as submitted. Successful applicants are required to submit a summary
report as soon as possible after submitting the reimbursement request, but not later than August
31, 2011. Failure to submit a report will result in ineligibility far future funding.
/a-~~'09
Date
~a-l P~
Date
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City of Dublin
Fiscal_Year2010 201.1
Application for Funds
COLLABORATION AGENCY
AFFIDAVIT FORM
o This form is to be completed by each collaboratang organization as named by the
applicant agency in the proposed project/program.
o Completed forms must be submitted at time of application.
Collaborating Agency Name: _
Dublin Rotary
Agency Division/Department:
N/A
Project/Program Title: _Third Grade Dictionary Give-Away
Project/Program Role Description (i.e., facility spaee, staff support, etc.):
DPIE and Dublin Rotary pay for and distribute dictionaries to every third grade student in
Dublin Unified School District
Agency Project/Program Contact Person Don Biddle
Title
Board Member Dublin Rotary
Phone 925 828-2827 Email
_dondonnab 1 @aol.com -
I attest that the applicant agency and our organization agree to work collaboratively to implement
the proposed project/program as identified in the FY 2010-2011 funding application.
Executive Director
Date
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. ~ ~ _
~ ~al~-~~
~
Project/Program Contact erson Date
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CIT~ OF DUBLIN
Fiscal. Year 2010-2011
COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM
SUMMARY REPORT
(Summary Report must be completed and submitted prior to August 31, 2011.)
AGENCY NAME
MAILING ADDRESS:
TELEPHONE:
PROJECT/PROGRAM NAME:
TOTAL FUNDING AMOUNT AWARDED
$ .
TOTAL REIMBURSEMENT RECEIVED
$
1.) How has tlie PROJECT/PROGRAM addressed an unmet community need and improved
the quality of life for Dublin residents. (Additional page may be added, if needed):
2.) Please evaluate the success of your project/program. Were the goals outlined in the
application met? Was the project/program carried out efficiently? Please use the objectives
identified in your application to discuss your program/project's success and impact. Include any
documentation/datalrecords you have that support your conclusions.
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AGREEMENT BETWEEN
CITY OF DUBLIN
AND
(insert or~anization name~
THIS AGREEMENT, dated for identification this _ day of 2010, is entered into
between the City of Dublin ("City") and Dublin Partners in Education.
RECITALS
A. Dublin Partners in Education has asked City to contribute $ 15,000.00 LFifteen
thousand Dollars) for use by DPIE to cover _Operating costs
in order to provide the services as described in E~chibit A. The services rendered pursuant
to this agreement will be for the period July 1, 2010 through June 30, 2011.
B. City has determined that it is in the interest of the residents of the City of Dublin to make
a donation of $ ( Dollars) for such purpose, provided certain
conditions are met to ensure that the services will benefit the residents of City.
AGREEMENT
City and Dublin Partners in Education agree as follows:
l. Recitals
The foregoing recitals are true and correct and are part of this agreement.
2. City Donation
City shall donate $ ( Dollars) to be used by DPIE to be used for
operational support for Programs as described in Exhibit A to this
Agreement. The donation shall be paid upon invoice to the City.
3. Records
Dublin Partners in Education shall maintain records for project/program review,
evaluation, audit and/or other purposes and make them available to City upon request.
4. Periodic Reports
Upon request by City, DPIE shall provide reports describing the progress made by DPIE
accomplishing the goals and objectives outlined in the work plan.
CITY OF DUBLIN
Dated:
Dated: %2 ° ~y- ~ ~
By:
J ni L. Pattillo, City Manager
By:
Title • ~,~ ~e . ~! R~C~6 (~
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