| JOHN RANDOLPH FOUNDATION
GUIDELINES FOR
COMMUNITY CONTRIBUTION REQUEST
Purpose: Guidelines regarding “Community
Contribution Request”
Mission: John Randolph Foundation’s mission
is to identify and support health related programs and services
and quality of life improvements.
Policy: A request for a community contribution
may be made by an
organization at any time during the year. However, an organization
can receive no more than one contribution per calendar year.
Requests exceeding $1,000 must adhere to the Foundation’s
grant review process.
Procedure: To request a community contribution,
an organization must meet and follow criteria and procedures
as outlined in this document.
1. A community contribution request may be considered
if the organization applying provides services that are essential
to the well-being of the citizens of the John Randolph Foundation
Service area which consists of Hopewell and the surrounding
areas [Prince George, Chesterfield (South of 288 & East
of Courthouse Road), Petersburg, Colonial Heights, Ft. Lee,
Dinwiddie, Surry, Sussex, Charles City, and Southeast Henrico
(Varina- South of I64)].
2. The following entities may apply for a “community
contribution” from the John Randolph Foundation:
A. A community-based public or private non-profit
organization with
501(c)(3) tax-exempt status and classified as a 509(a) non-private
foundation.
B. An applicant seeking tax-exempt, non-private
foundation status under
501(c)(3) and 509(a). Please note: No funding will be awarded
without
a final determination letter from the IRS.
C. A tax-exempt operating foundation under
501(c)(3) and 4940(d)(2).
D. A government instrumentality or political
subdivision.
3. The organization must provide well-defined services and/or
programs to the residents of our
service area, which are consistent with the mission of the John
Randolph Foundation.
4. The organization must submit a “community contribution”
request application which includes information regarding: (a)
organization’s mission; (b) services and/or programs provided
by the organization; (c) utilization of contribution; (d) specific
need the contribution will address; (e) effectiveness of this
contribution; (f) target population to be served; (g) anticipated
results and impact on the community; (h) a time frame of activities;
(i) local leadership and community support for the project;
(j) total amount requested and how much financial and in-kind
support can be obtained from other sources; and (k) list contact
person, name of organization, address and phone number.
5. The organization receiving a “community contribution”
must provide a summary within three months after receiving the
contribution which addresses the following: the extent to which
the organization has met its objectives; demonstration of community
commitment and support for the organization; how the organization
delivered services and programs.
6. All “community contribution” requests will be
reviewed by the Grant Committee Chairman. Assuming funds are
available from the grant budget of the given year, the Grant
Committee chairman shall have the authority to act on behalf
of the Grant Committee, if the nature of the request requires
immediate action. Otherwise, requests will be considered at
the next Grant Committee meeting. If funds are not available,
a recommendation for additional funding may be made at the next
regular board meeting or at a called meeting of the Executive
Committee, depending upon how quickly funds are needed. The
Grant Committee will report to the Board of Trustees at the
next regularly scheduled meeting on all community contribution
requests.
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