Edelman 5-5-5 Community Grant Application

THE PROGRAM
y Edelman will provide in-kind public relations services including program ideation and planning valued at $10,000 to five Chicago-area, non-profit organizations that focus on eradicating poverty and hunger. Edelman will work with five community organizations to provide five individualized and actionable PR Plans in five consecutive days. Each six-hour session will include a brainstorm to take place at Edelman Chicago offices the week of March 19, 2012. It will be facilitated by an Edelman expert and include a broad team of staff. It will culminate with a PR plan outlining recommendations for traditional, hybrid, social and owned media. Applications are due by March 1, 2012. Grant winners will be notified by March 12, 2012.

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ORGANIZATION QUALIFICATIONS
y y y y y Organization must have been in existence for at least one year and have 501-C (3) certificate or appropriate government certificate from its headquarters location. Organization must be non-profit or not-for-profit. Organization must be self-sustaining. Organization must demonstrate a need for PR resources. Organization s mission should focus on eradicating poverty and hunger in the Chicago area.

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APPLICATION FORM
Instructions: This form is to be completed by a representative from the nominated non-profit organization. Please abide by the word limits listed below. Non-Profit Overview Organization name: Address: City: Country: Telephone: Email: Website: Executive Director: Name/Title of contact person: Total organization budget of current year: Primary service category of organization Hunger Poverty/Homelessness Social Services Community/Economic Development Other _________________________

State/Province/County: Fax:

Zip:

Telephone: Telephone: $

Summarize the organization s mission and describe the need the organization meets in the community. (Limit 250 words)

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PR Resources Please describe the organization s current PR resources and activities including dedicated staff or partner agencies. (Limit 250 words)

Goals and Objectives Please describe the organizations goals and objectives that could be met with additional PR support (Limit 250 words)

Attachments (Please provide in the following order)

A. Finances 1. Audited financial statements for the last fiscal year, if available, or Form 990. If neither document is available, include unaudited financial statement. 2. Current year s operating budget to include both projected expenses and revenues. Categorize expenses under program, general and administrative and fundraising. 3. A list of foundations, corporations or governmental agencies that funded the organization in the last fiscal year, including amounts contributed ($1,000 and above). B. Other Supporting Materials 1. Verification of the organization s or fiscal agent s tax-exempt status under Section 501(c) 3 and 509(a) of the IRS code. If using a fiscal agent, please include Letter of Authorization. 2. Latest annual report or a summary of the organization s previous year s activities. 3. Current board list with related employment affiliation. 4. Letters of support and/or reviews (if applicable).

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Exclusions
Grants will not be considered for: y Specific individuals y Tickets for contests, raffles or other activities with prizes y Religious organizations (unless the request is specifically for a program offered to the public on a nondiscriminatory basis and without regard to the recipient s religious affiliation) y Endowments y Debt-reduction campaigns y Political or partisan organizations or events y Organizations involved with political activity or lobbying y Organizations that discriminate based on age, race, religion, sex, creed, or sexual orientation y Capital campaigns and expenditures

Signature of Authorized Official __________________________________Date: ___________________ Name/Title: _________________________________________________________________________

MAIL COMPLETED FORM AND ANY REQUIRED ENCLOSURES TO: Ryan Richert 200 East Randolph Street 63rd Floor Chicago, IL 60601 Tel: 312.240.2743 Fax: 312.240.0750 Email: ryan.richert@edelman.com Web Site: http://www.edelman.com

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