Thank You for you Applying!
In order to complete your application, please answer the following questions and send them to:
222 Merchandise Mart
Chicago, IL 60654
- Organization type and organizational structure
- Identify the primary contact person for your organization who will lead the project/program (name, title, e-mail, phone)
- Identify organization’s list of officers
- Organization’s Mission
- Submit mission statement and focus of current programs
- Include service population (number of actual HIV/AIDS related cases). We want to understand your focus on HIV/AIDS and how your funding request relates.
- What significant difference does your agency provide?
- Description of Project/Program you would like to use DIFFA/Chicago Funding for
- Describe the project/program
- Impact: What impact do you intend to make with the program.
- Evaluation: How will you measure success?
- Time Line: What is the schedule? This does not need to be a one year project.
- Project Budget: Submit a detailed budget of up to $25K that will support our evaluation process and defines specifically the DIFFA grant will be we used:
- Or Program Funds: Define how our grant will sustain an existing or new program.
- Since our grants are not restricted, please share with us how funds are used to most impact your program/project.
- Describe a post grant award communication strategy to allow DIFFA to get updates on your program and feedback on measurable results of the project we are supporting.
- Submit a financial statement from the past two (2) fiscal years
- Submit a list of your top 10 funding sources and amounts for the previous two (2) years
- If you have received an Excellence in Care Award, provide a brief description of how the funds were used. How many individuals were impacted?
- Submit information to demonstrate operating expense to direct client care ratio.
If you have any questions, feel free to reach out:
Fax: (312) 644-6413