Congratulations on being approved for funding from United Way of Southern Nevada. Please complete this Project Planning Survey.

The project planning survey must be submitted before a funding agreement is sent to your organization. Contact MeganC@uwsn.org with questions.

You can review the UWSN Community Impact Logic Model at this link.

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* 1. Organization Name

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* 2. Primary Contact Name

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* 3. Primary Contact Email Address

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* 4. Please confirm that your organization would like to officially accept the grant funding approved by the UWSN Board of Directors.

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* 5. Anticipated Project Timeline
Is this program year-round, seasonal, or ending before June 30, 2023?

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* 6. Please describe the people your program will serve.
Include information on age, gender, race, ethnicity, socio-economic status, and special population groups.

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* 7. Please describe the geographic reach of your program.
Remember to note relevant zip codes and/or neighborhoods for the people you *currently* serve, and if you have an understanding of where future participants will come from.

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* 8. What is your primary program output/activity?
(e.g. # of children accessing health services, # of participants in case management, # of students enrolled, etc.)

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* 9. How many people do you plan to serve using the approved grant funds?
(This may be the same or different from your proposal, due to funding allocations)

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* 10. Please list any other key services people receive by participating in your program.
Also indicate the estimated number of people that might receive those services (all, some, #, %).

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* 11. Please describe how you measure/collect information on program outputs/activities?

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* 12. What is your primary program outcome?
(e.g. % of students graduating high school, % of people gaining full-time employment, % of people obtaining a recognized career credential, etc.)

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* 13. How many / what percent of program participants do you expect will achieve this outcome during the year (July 1, 2022 - June 30, 2023)?

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* 14. Please list other key program outcomes participants can achieve by participating in your program.
Also indicate the estimated proportion of people that might achieve those outcomes (all, some, #, %).

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* 15. Please describe how you measure/collect information on program outcomes?

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* 16. Please select the long-term impact goal your program contributes to.
You won't have to measure this one. We track these indicators internally.

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