Children’s Trust Fund
GRANT APPLICATION INSTRUCTIONS
Carefully read all instructions and guidelines that relate to your program
A. General Instructions
1. Type the application.
2. Submit additional forms as requested on Application Checklist.
3. Confine the narrative to the space provided. Do not submit any additional
material as an appendix, unless listed on the attachment checklist above.
4. Complete applications must be received at the Children’s Trust Fund by the specified deadline noted.
Copies sent by fax will NOT BE ACCEPTED.
5. Send all application materials to the Children’s Trust Fund, 450 Capitol Avenue, Hartford, CT 06106.
B. PROGRAM FACE SHEET INSTRUCTIONS
Indicate whether this program is funded by State or Federal funds.
1. Indicate type of program or service.
State the program name and location where services will be delivered.
2. Indicate ONLY the Primary Targeted Population to be served. Note either children or parents, or both by
3. Indicate the COMPLETE LEGAL name of your agency. State your mailing address (not the program
4. If you are applying as an agency state your Federal ID (FEIN) number; or a city or town state your town
5. Specify the towns to be served by this program; or if your program will serve an entire region, state
6. Indicate the name, telephone, and fax number of the Executive Director.
7. Indicate the person that may be contacted regarding program issues.
8. Indicate the person that may be contacted regarding budget issues.
9. Indicate the funding period.
10 & 11. Indicate the Fiscal Year information requested on each face sheet. State the amounts and
percentages of Income and Expenses for this program for each fiscal year. The total of #10 must be the
same as the total of #11.
C. PROGRAM NARRATIVE INSTRUCTIONS - Follow Carefully
1. Program Description:
Provide a thorough, yet succinct, description of the services to be provided during the contract period.
Specify only those services to be carried out under this award. Do not reduce the type. All program
guidelines indicated in the RFP must be addressed.
2. Provide a description of the target population for the program, including age, gender, ethnicity, income
level, geographic area, and any other factors that characterize the group. (i.e. adverse living conditions,
family structure and dynamics, physical and/or emotional health, educational status, etc.)
3. Describe the service model or approach the program will utilize. Provide the rational behind this program
4. Briefly describe the staffing plan.
5. Not Applicable leave blank
6. A. Subcontractors: List agencies or individuals with whom you have an agreement to provide services for
this program, and for which there will be a monetary compensation. Identify the agency or individual and
state the specific services they will provide for this program. Signed letters specifying the services,
compensation and other agreements must be attached.
B. Coordination: Identify any agencies that will be directly involved in implementing the program and
that will not receive any compensation for the service. State the service that each listed agency will
provide. If the service is critical to the implementation of your program (i.e. primary referral source,
training, resource for volunteers) letters of agreement must be attached.
7. Provide a breakdown of the Primary Clients to be served by this program.
The number must agree with the number indicated on Page 1 of this application. Explain how the numbers
were determined. Identify the age range of children and youth to be served by this program. Children’s
Trust Fund prevention programs should serve only a small percentage of CTF Clients - 1 to 2%.
8. PROGRAM OPERATING HOURS
A. Indicate the specific hours the PROGRAM (not agency) will be in operation. These are the hours in
which the contractor agrees to provide program services directly or through another agency (agreement
must be attached).
B. Indicate the total number of weeks per year the program will be in operation. DO NOT subtract weeks
to account for staff member vacation schedules. DO indicate whether the program is funded for a partial
year or if the program operates on a school calendar year or full year schedule. If the entire agency
(program) closes during certain weeks (i.e. Christmas) DO not include these in the total weeks of
program operation per year.
C. Describe how a request for service after normal hours will be handled, and how emergency referrals
after program hours will be managed. Please explain any on-call arrangements.
9. Indicate the estimated percentage of time that service will be delivered at each of the settings listed during
the contract period.
10. The information in this chart must agree with the staffing pages of the budget. Indicate all staff
(including those to be hired) who will be providing services in the program, whether funded by CTFC or
other sources. For each of the categories, indicate both the full time equivalency of all staff in the
particular category as well as the actual number of staff who are included in the FTE’s. Some staff may
be recorded twice in the chart if they work in both direct service and administration. For staff to be hired,
complete the FTE’s and # of positions. You do not need to identify gender or ethnicity for those to
11. PROJECT WORK PLAN. Present a work plan for the program services you previously described in #1.
The work plan included activities for the entire program, not just the CTFC funded portion. Attach as
many additional pages as necessary.
THE WORK PLAN MUST INCLUDE:
A. GOALS - Please note stated program goals in the Request for Proposal
B. OBJECTIVES - State specific result to be achieved. Include major steps to be taken to
implement the program; i.e. recruit program participants, provide supervision to staff.
C. ACTIVITIES -Actions which describe the steps to be taken to achieve the objectives. Clearly
state who, how, where and when.
D. STAFF POSITIONS RESPONSIBLE - Indicate the specific staff person who will be
responsible for each activity.
E. EXPECTED OUTCOMES AND MEASURES OF SUCCESS -
Indicate what you hope to accomplish. Describe how this accomplishment will be measured both
qualitatively and quantitatively. Outcomes and measures of success should relate to the objective,
not the activities, and should be client/participant related whenever possible.
F TIMETABLE - Indicate specific dates when the work on an objective and related activities will
begin and end. DO NOT USE “ongoing” or “July - June” in the timetables. Be as specific as
Children’s Trust Fund
450 Capitol Avenue
Hartford, CT 06106
PROGRAM FACE SHEET
State Funds_______ Federal Funds_________
1) Type of Program/Service:____________________________________________________________
Program Location: _________________________________________________
2) PRIMARY CLIENTS ARE THOSE SERVED FOR THE FISCAL YEAR STATED BELOW ONLY
PRIMARY CLIENTS ONLY
# Children ___________________ # Families __________________ # Parents ___________________
3) Legal Name of Contractor:
4) Federal Identification No./Social Security No./ Town and Dept. Code:
5) Towns to be served:
6) Executive Director Telephone #: Fax #: ______________________________________________________________________________________________________________
7) Program Contact Person: Telephone #: Fax #: ______________________________________________________________________________________________________________
8) Fiscal Contact Person: Telephone #: Fax #: ______________________________________________________________________________________________________________
9) FY_________Funding Period Begin Date: Ending Date:
10) FY________ EXPENSES 11) FY__________ INCOME A. Direct Service A. Amount Requested
Personnel $_____________ _____% from CTFC $____________ ______%