Giving Collective Intake Form Agency Name*Initiative Name*Date of Initiative* Date Format: MM slash DD slash YYYY Name(s) of person(s) who prepared this application*Provide a description of your initiative, including specific goals.*How does this initiative support your organization’s mission?*Please check all that apply* This is an existing initiative that we seek to expand This is a pilot initiative with plans to continue if successful This is a one-time initiative This is a new initiative that is intended to be ongoing If this is an existing initiative, how is it currently funded?Describe the target population you serve and how this initiative will impact that population (include how many people this initiative will impact).*Have you previously served this population? If yes, please describe and give examples.Please indicate which of the following six community impact areas this initiative applies (check all that apply). Jewish Experience, Engagement and Learning Caring for Jewish Buffalo Promoting a Civil and Just Society Connection to Israel and Global Jewry Preserving our Legacy Sustaining and Securing our Community Describe the community impact(s) on Jewish Buffalo selected above.What methods and criteria will you use to evaluate and measure the initiative’s impact according to your intended goals?*If applicable, with what other organizations will you collaborate? How will you share responsibilities? What other organizations, if any, are helping to fund this initiative beyond this support?Budget Please upload a detailed budget of expenses and income for this initiative. Include all costs related to staff, training, materials, supplies, marketing, and any other expenses. Include all anticipated income, participation fees, and other funding. Upload Budget Drop files here or In addition, please specify the following information:Total amount of agency funds committed to this initiativeTotal amount of donor funds committed to this initiativeTotal amount of fundraising support you are requesting for this initiativeSponsorship / Recognition OpportunitiesDescriptionDonation Amount Please note: Summary Impact Report will be due 30 days after the completion of the initiative. If your organization or agency is interested in seeking assistance with a larger campaign or ongoing initiative, please contact Irv Levy, Executive Director, Foundation for Jewish Philanthropies, at Irv@jewishphilanthropies.org.