State Giving Program Application Example

Walmart Foundation State Giving Application Preview
Preview Form
This is an example of the application questions with which you will be presented. It is recommended
that you compose the answers to the paragraph questions in a word processing program and then cut
and paste that text into the online application.
Contact Information
Please select or enter the contact information for the Grant Preparer, President/Executive Director,
and/or Public Relations contact for this request.
*First Name Instructions:
Meghan Enter the contact's first name.
*Last Name Instructions:
Zalewski Enter the contact's last name.
*Contact Title Instructions:
Grant Writer and Marketing Enter the contact's title.
Associate
*Address Instructions:
318 Fifth Street SE Enter the contact's address.
*City Instructions:
Cedar Rapids Enter the contact's city.
*State
Instructions:
Iowa
Enter the contact's state.
*Zip Instructions:
52401 Enter the contact's zip.
*Telephone Instructions:
319-365-2263 ext 6139 Enter the contact's telephone number starting with the Area Code.
Instructions:
*E-mail Address
mzalewski@waypointservices.org Enter the contact's e-mail address. Please ensure the accuracy
of this email address as it will be used for correspondence.
*C ontact Type
Development Staff
Instructions:
Select the contact type that best describes the contact's role.
*C ontact's Role
Employee Instructions:
Please choose the item that best describes the contact's
relationship to the organization.
Organization Profile
Official Name Instructions:
Waypoint Name associated with specific tax ID in the IRS business master
file.
*Legal Name Instructions:
Waypoint Enter the organization's legal name.
AKA Name Instructions:
(Text)(100 character maximum) Enter the AKA Name of the organization (if applicable).
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*Address Instructions:
318 Fifth Street SE Enter the organization's mailing address.
*City Instructions:
Cedar Rapids Enter the organization's city.
*State
Instructions:
Iowa
Enter the organizations state.
*Zip Instructions:
52401 Enter the organization's zip code.
*Telephone Instructions:
(319) 365-2263 Enter the organization's telephone number.
*Organization Mission Instructions:
Waypoints mission is to strengthen Provide the organization's mission statement.
and empower individuals who are
homeless, living in poverty, or
victims of domestic violence. They
also strive to give children access to
gaining the essential skills vital to
reaching their full potential through
quality child care. The perspective of
Waypoint is not only to assist and
provide necessary resources to
domestic violence victims in need,
but to empower these victims to get
out of the current unsafe situation
that theyre in and improve their own
lives.
*Facebook Instructions:
https://www.facebook.com/waypointserv Enter the organization's Facebook page (Enter N/A if not applicable)
ices/?fref=ts
*Twitter Instructions:
@waypoint1911 Enter the organization's Twitter handle (Enter N/A if not applicable)
*Website Address Instructions:
318 Fifth Street SE Enter the organization's website address (Enter N/A if not
Cedar Rapids, Iowa 52401 applicable)
Request History
Instructions:
*Previous Funding
(Yes/No) Has the organization ever received funding from the Walmart
Foundation State Giving Program?
Previous Funding Date Instructions:
(Date) Enter the date that funding was received.
Previous Funding Amount Instructions:
(Currency)(20 character maximum) Enter the previous funding amount.
Instructions:
Previous Funding Description
(Paragraph)(2000 character maximum) Briefly describe the funded project and how Walmart Foundation
State Giving funds were used.
Program Information
Please complete the fields below with information regarding the program for which the organization is
requesting Walmart Foundation State Giving funds.
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*Program Title Instructions:

Domestic Violence Victim Services Enter the title of the proposed program.
Program
*Program Focus Area
Other
Instructions:
Select the Focus Area that best fits the proposed program.
*Program Focus Category

Other
----Health and Human Services
Instructions:
Select the Focus Category that best fits the proposed program.
Find the Focus Area value you selected in the question above and
then select a value from those given beneath that heading.
*Program Subcategory Instructions:

(Single-Select List) Select the Subcategory that best fits the proposed program. Find
the
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Focus Category value you selected in the Program Focus Category

-Awareness/Prevention question above and then select a value from those given beneath
----Crisis Support that heading.
----Other Basic Needs
*Unmet Need/Problem Statement Instructions:

(Long Paragraph)(32500 character Briefly define the problem or issue the program is designed to
maximum) address. Why is it important? How does the problem/issue affect the
target population? What is the organization's plan to address the
According to the National Coalition problem/issue?
Against Domestic Violence, each
minute almost twenty people are
subjected to violence by their intimate
partner. One in every three women
and one in four men will be victims
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of domestic violence in their

lifetimes, with one in fifteen children
as witnesses. The National Coalition
Against Domestic Violence stated that
in Iowa alone, 6,628 domestic
violence incidents were reported in
2011, and it has been found that only
about half of domestic violence is
actually reported.
One of the most difficult aspects of

domestic violence, is achieving the
means to escape. A major aspect of
domestic violence is financial abuse.
This can mean anything from limiting
spending to stealing or hiding credit
cards and not allowing victims to
work. Moreover, victims often face
medical charges for injuries inflicted
by their partners. According to a
study released by the Center for
Disease Control, charges are roughly
$948 a year for women and $387 a
year for men. This is one of the most
common reasons women are forced to
stay with their abusers. Without
access to the necessary finances it is
nearly impossible for women to
acquire the resources needed to leave
their abusers and find a life apart
from violence.
Waypoint is an organization in Cedar

Rapids, IA with a satellite office in
Dubuque, IA that helps women find
their way out of abusive relationships.
They help women with the initial
financial burden that is a part of
fleeing domestic violence. This is
highly individualized, but generally
comes down to transportation and
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housing. Transportation generally

accounts for gas money, bus or plane
tickets and U-Haul moving vehicle.
Waypoint also helps women pay for
storage, down payments and first
months rent for housing and hotel
room, as well as penalties for ending
leases early for housing for storage
units.
*Fund Use Instructions:
Waypoint is asking for $5,000 that Provide a brief narrative of how funds will be used, if awarded.
will go towards the various victims of
domestic violence who are trying to
flee their current unsafe situation. As
stated before, this money would
provide approximately 25 more adults
and their children with the resources
they need to build new lives. Since
each situation is different depending
on what that specific persons
financial needs are, its hard to
pinpoint an exact plan for
implementation. Some victims may
need a bus ticket as well as a security
deposit and first months rent while
others just need a gas card. Therefore,
the amount of money that is being
distributed to each person varies and
is not a fixed amount. However, all
that we know right now is that the
current funds that are available to
help with fleeing financial costs for
domestic violence victims are not
nearly enough. This is why the
Domestic Violence Safety Net
Program is so essential because it
helps lead to long-term safety for
Dubuque domestic violence victims
and their children by providing
financial assistance for housing and
transportation needs. Moreover,
Domestic Violence Safety Net
Program includes offering housing
assistance when victims and their
children need to relocate due to an
abusive partner; covering
transportation costs and moving truck
rentals to help attain safety;
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transportation assistance supporting

victims utilizing support services or
attending court appointments
connected to victimization; and other
costs related to fleeing domestic
violence.
*Program Description Instructions:
Since 1894, Waypoint has devotedly Provide a brief synopsis of what the proposed program will
worked to improve the lives of those achieve.
that are in need. Waypoint first began
as the Cedar Rapids chapter of the
Young Womens Christian
Association (YMCA) and has always
specialized in empowering women to
improve their current unsafe situation.
Since the beginning, Waypoint has
remained dedicated to helping
individuals move forward through
proactive services and resources
including the Shelter and Housing
Program, Domestic Violence Victim
Services, and high quality, affordable
child care. Earlier on, women who
traveled to the city seeking
employment looked to the YMCA for
help. Over the years, Waypoint
continued to meet the needs critical to
womens lives in a variety of ways,
including providing support for those
experiencing domestic violence.
Eventually, Waypoints focus shifted
towards addressing the areas need for
critical support services, separating
itself from the mission of the YMCA.
Today, nearly 125 years after its
foundation, Waypoint serves
individuals from all backgrounds
through its Housing Program,
Domestic Violence Victim Services,
and child care. Waypoints rich
tradition of assisting domestic
violence victims and children in
Cedar Rapids as well as surrounding
Iowa communities persists as
Waypoint continues to find new ways
to help individuals in crisis. Waypoint
has proven to be an effective
organization serving over 7,000
individuals in 7 Northeastern Iowa
7
counties this past fiscal year as well

as providing high quality child care to
500 children each day.
Waypoint is a non-profit agency

which provides a variety of services
to domestic violence victims to the
following counties; Benton, Black
Hawk, Buchanan, Delaware,
Dubuque, Jones, and Line. The
services provided include advocacy,
support groups, community support,
allied professional support and a 24/7
resource and support line.
*Primary Target Population Instructions:

(Paragraph)(2000 character maximum) Describe the target population for the proposed program.
This financial assistance could help

any of the previously stated 6,628
victims of domestic violence who
reside in Dubuque County to leave
their abusers.
What state is this request for? Instructions:

Iowa (Single-Select List of U.S. states including
Puerto Rico and Virgin Islands
Instructions:
*Area Served (User- Enter the county or counties served by proposed program one at
Defined List) a time and click the "Add to List" button after each entry.
If you serve all counties in a state then simply enter "All counties".
Dubuque County
Dubuque County
*Desired Results Instructions:
Through providing financial Identify the major program goals and outcomes. What are the
assistance for domestic violence anticipated benefits for the target population and the impact the
victims who are attempting to flee organization expects to achieve as a result of the proposed program?
their harmful situations, our goal is to
increase the amount of domestic
violence victims who are able to do
this by providing them with the
necessary financials to do so.
Providing fleeing financial assistance
to domestic violence victims includes
aspects that are grouped into three
specific areas; transportation and
moving truck costs, housing
assistance and hotel costs, and
miscellaneous costs. Transportation
and moving truck costs include
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helping victims pay for bus tickets,

plane tickets, gas cards and train
tickets. Housing assistance and hotel
costs include helping victims pay for
their security deposit and the first
months rent of their house, phone
cards or any hotel expenses they may
have. Miscellaneous costs include
basic needs such as shampoo,
toothbrushes, body wash, deodorant,
razors, tampons, diapers, diaper
cream, cleaning supplies, toilet paper,
paper towels, pull ups, grocery store
gift cards and department store gift
cards. All aspects provided by fleeing
financial assistance help domestic
violence victims flee the current
dangerous situation that theyre in
and help them to maintain suitable
living conditions as they relocate.
Currently, domestic violence victims
from other areas outside of Dubuque
are unable to relocate because the
current fleeing finan cial assistance is
used towards a victim trying to
relocate in Dubuque only. This is
problematic because financial
assistance is limited in Dubuque
meaning that Waypoint has to reach
out to other non-profit organizations
in order to help all the women who
come to their program for financial
assistance. Having enough fleeing
financial assistance will increase the
amount of victims that Waypoint can
provide this necessary service to. We
are looking to increase the amount of
domestic violence victims who can be
provided with the necessary financials
needed in order to flee their current
unsafe situation.
*Program Sustainability Instructions:
(Paragraph)(2000 character maximum) Briefly describe how the proposed program will be sustained
and/or integrated into the organization's work if Walmart or its
Sustainability is a concept that is Foundation is unable to support the program.
difficult to discuss when looking at
this specific program. Its hard to
pinpoint how the program will
9
continue after the funding ceases

from this foundation because funding
is essential in order to help this
organization continue to thrive.
However, Waypoint is an organization
that has been around for many years
and one that has deemed to be a
successful program. The needs of
these domestic violence victims is
what should be greatly considered
when deciding whether to continue to
fund this program or not. This
program provides victims with not
only necessary financial services that
victims need in order to flee their
unsafe situation, but necessary well-
being services in order to help the
victims cope with what theyre going
through. If this program were to no
longer exist, these victims, especially
the victims within the Dubuque
county area, would have nowhere to
go. If this program continues to prove
to be successful as it has been for
many years, Waypoint will continue
to seek other funding sources.
*Organizational Budget Instructions:
(Currency)(20 character maximum) Enter the organization's total operating budget.
*Program Budget Instructions:
(Currency)(20 character maximum) Enter the total program budget.
*Requested Grant Amount Instructions:
Enter the dollar amount you are requesting for this project. The
$5,000 dollar amount requested must be $25,000 or greater.
Budget Breakdown
Please complete the following section based on the budget for the proposed program.
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*P rogram Budget Items Instructions:

Personnel Costs Please enter the requested amount of each item below.
Materials and Supplies Personnel Costs: Total amount of program-related personnel
Other Direct Costs expenses including: compensation, benefits, insurance, etc.
Indirect Costs Compensation (including benefits, insurance, etc.) is
limited to 50% of any single program-related position. You
$2,000- Transportation and Moving may request funds for multiple positions.
Truck Costs Materials and Supplies: Total of all program-related supplies
and materials.
$2,000- Housing Assistance and
Hotel Costs Other Direct Costs: Total of all other program-related direct
costs.
$1,000- Miscellaneous Costs Related Indirect Costs: Total of all non program- related expenses
to Fleeing Domestic Violence including: non program-related staff, shared supplies, rent,
occupancy, utilities etc. Indirect costs cannot exceed 10%
of total request amount.
Instructions:
Please list the positions, amounts and percentage of total
compensation for each position included in the above Personnel Costs
total. Compensation (including benefits, insurance, etc.) is limited
to 50% of any single program-related position. The request may
include funds for multiple positions.
*Explanation of Personnel Costs
(Paragraph)(2000 character maximum) Example:
Program Manager- $25,000 (50% time)
Executive Director- $25,000 (50% time)
If the organization is not requesting support for Personnel Costs,

enter N/A.
Instructions:
Please provide a line-item breakdown of all items included in the
above Materials and Supplies total.
*Explanation of Materials and Supplies Example:

(Paragraph)(2000 character maximum) Books - $5,000
Computers - $5,000
If the organization is not requesting support for Materials and

Supplies, enter N/A.
Instructions:
Please provide a line-item breakdown of all items included in the
above Other Direct Costs total.
*Explanation of Other Direct Costs Example:

(Paragraph)(2000 character maximum) Travel - $3,000
Staff Training - $2,000
If the organization is not requesting support for Other Direct

Costs, enter N/A.
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*Explanation of Indirect Costs Instructions:

(Paragraph)(2000 character maximum) Please provide a line-item breakdown of all items included in the
above Indirect Costs total. Indirect Costs cannot exceed 10% of
total requested amount.
Example:
Rent - $4,000
Electric - $2,500
If the organization is not requesting support for Indirect Costs,

enter N/A.
Demographics
Please provide specific information regarding the populations served by the program for which the
organization is requesting Walmart State Giving funds.
Instructions:
*People Served Enter the projected number of unduplicated individuals served as
(Number)(15 character maximum) a result of this funding request. An individual who receives more
than one service should only be counted once for this question.
*G end Instructions:
er Enter the number of people in each gender type that the
Female organization plans to serve as a result of this funding request. The
total must equal the number entered in the People Served field
above.
*Age Group
Unknown/Unreported ages Instructions:
Enter the number of people in each age range that the
organization plans to serve as a result of this funding request. The
total must equal the number entered in the People Served field
above.
*Ethnic Background
African American or Black Instructions:
Enter the number of people of each ethnic background that the
American Indian or Alaskan organization plans to serve as a result of this funding request. The
Native total must equal the number entered in the People Served field
Asian and Pacific American above.
Islander
Hispanic or Latino
Multi-ethnic
White
Unknown/Unreported
Veterans Instructions:
(Yes/No) Will the proposed program serve U.S. military veterans?
Veterans Served by Gender Instructions:
Please provide the total number of veterans served as a result of
Unknown/unreported this funding request. This does not include military family members,
only people who have served in the military themselves.
Veterans Served by Age Group
Instructions:
Unknown/Unreported Please provide the number of veterans served in each age group
as a result of this funding request. This does not include military family
members, only people who have served in the military themselves.
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Program Metrics
Please provide additional detail on the projected impact of the proposed program by completing the
fields below.
Service Type
(Multi-Select List)
Instructions:
Grocery or Food Distribution Please specify which service(s) the proposed program will provide
Benefits Enrollment to the organization's target population. To choose more than one
Capacity Building service type, hold down Ctrl and click (Cmd and click for Apple
computers).
Number of people served Instructions:

Children (0-17) Please enter the projected number of people in each age range
Adults (18-59) that will be served as a result of this funding request. Please note: the
Seniors (60+) age ranges represented here are not the same as the age ranges in
the Demographics section.
Instructions:
Congregate Meals
unreported Please provide the projected number of congregate meals
provided as a result of this funding request.
Instructions:
Home Delivered Meals
unreported Please provide the projected number of home delivered meals the
organization will provide through this funding request.
Federal Meal Reimbursements
Instructions:
Please provide the projected number of meals that will be
reimbursed through the organization's participation in any of the
federal programs listed below.
Site/Location
Types
Other Locations Instructions:
Please enter the number of each type of site the organization
intends to support as a result of this funding request. This does not
include home delivered meals.
Instructions:
Pounds of Food Distributed
unreported Please provide the projected total pounds of food distributed as a
result of this funding request.
Instructions:
Backpacks Distributed
unreported How many backpacks will be distributed as a result of this funding
request?
Instructions:
Average meals per pack
unreported Please provide the average number of meals contained in each
takehome food pack.
Instructions:
Average Pounds per pack
unreported Please provide the average number of pounds contained in each
take-home food pack.
Instructions:
Number of Sites
unreported Please provide the projected number of sites served as a result of
this funding request.
13
Instructions:
Households Informed
unreported Please provide the projected number of households given
information on federal benefits as a result of this funding request.
Instructions:
Households Assisted with Application Please provide the projected number of households assisted with
unreported application for federal benefits as a result of this funding request. If
no households were assisted, enter 0.
Households Enrolled
Instructions:
unreported
Please provide the projected number of households enrolled in
federal benefits programs as a result of this funding request. If no
households were enrolled through this program, enter 0.
People Instructed Instructions:
Up to 6 hours of instruction Please provide the projected number of people given instruction
More than 6 hours of as a result of this funding request.
instruction
Vehicles (Capacity Building) Instructions:
none Please enter the number of vehicles the organization plans to
purchase as a result of this funding request. If the organization does
not plan to purchase any vehicles, enter 0.
Instructions:
Vehicle Details Please provide details on the types of vehicles the organization
(Paragraph)(500 character maximum) plans to purchase as a result of this funding request. If the
organization is not requesting support to purchase vehicles, enter
N/A.
Instructions:
Equipment Details Please provide the details of equipment (type and number of
(Paragraph)(500 character maximum) units) that the organization plans to purchase with the use of this
funding request. If the organization is not requesting support for
equipment, enter N/A.
Number of people provided
Instructions:
career/support services
Male How many people could receive career or support services as a
Female result of this funding request? An individual who may receive more
Unknown/Unreported than one service should only be counted once for this question.
Job Skills Program Length Instructions:
(Number)(15 character maximum) How long (in days) is the proposed program?
Instructions:
Job Skills Program Duration What is the anticipated average number of hours in jobs skills
(Number)(15 character maximum) training programs that participants will receive as a result of this
funding request?
Instructions:
Job Training Please provide the total number of individuals served through
(No input required) each of the following services. If an individual receives more than
one type of service, count them once for each service type they will
receive.
Instructions:
Average Job Placement Rate
(Number)(15 character maximum) What is the anticipated average placement rate of those that
complete training as a result of this funding request?
Adult Basic Education Enrollment
Instructions:
Male
Female How many people does the organization plan to enroll in adult
Unknown/Unreported basic education services as a result of this funding request?
14
Occupational/Vocational Education
Instructions:
Enrollment
Male How many people does the organization plan to enroll in
Female occupational or vocational education services as a result of this
Unknown/Unreported funding request?
Soft Skills Training Enrollment
Male Instructions:
Female How many people does the organization plan to enroll in soft skills
Unknown/Unreported training services as a result of this funding request?
Adult Basic Education Completion
Male Instructions:
Female How many people does the organization anticipate completing
Unknown/Unreported adult basic education programs as a result of this funding request?
Instructions:
Completion
Male How many people does the organization anticipate completing
occupational or vocational education services as a result of this
Female
funding request?
Unknown/Unreported
Soft Skills Training Completion
Male Instructions:
Female How many people does the organization anticipate completing
Unknown/Unreported soft skills training services as a result of this funding request?
Job Training Credentials
Male Instructions:
Female How many people does the organization anticipate receiving
Unknown/Unreported credentials/certifications as a result of this funding request?
Job Placement Metrics
(No input required) Instructions:
Part-Time Positions Instructions:
Male Of those who will complete training as a result of this funding
Female request, how many people does the organization plan to place in
Unknown/Unreported parttime positions?
Full-Time Positions Instructions:
Unknown/Unreported fulltime positions?
Internships/Apprenticeships
Male Instructions:
Female Of those who will complete training as a result of this funding
Unknown/Unreported request, how many people does the organization plan to place as
interns or apprentices?
Self-Employed/Entrepreneur Instructions:
Female request, how many people does the organization anticipate
Unknown/Unreported becoming self-employed or entrepreneurs?
Temporary Employment Instructions:
Unknown/Unreported temporary employment positions?
15
Wrap-Around Services
(Checkbox List)
WIC
SNAP
Childcare Instructions:
Mental Health Services Please check all additional services that may be provided to
Financial Literacy individuals receiving job training services as a result of this funding
Transportation request.
Housing Assistance
Emergency Food Supply
Earned Income Tax Credit
Instructions:
Career Opportunity - Veterans
(Yes/No) Will the proposed program provide U.S. military veterans with job
skills training and/or placement assistance?
Instructions:
Veterans-Specific Metrics Please provide the total number of veterans served through each
(No input required) of the following services. If a veteran receives more than one type of
service, count them once for each service type they will receive.
Average Job Placement Rate - Instructions:
Veterans (Number)(15 character What is the anticipated average placement rate for veterans that
maximum) complete training as a result of this funding request?
Adult Basic Education Enrollment -
Instructions:
How many veterans does the organization plan to enroll in adult
Veterans basic education programs as a result of this funding request?
Male
Female
Unknown/Unreported
Instructions:
Enrollment - Veterans
Male How many veterans does the organization plan to enroll in
Soft Skills Training Enrollment -
Instructions:
How many veterans does the organization plan to enroll in soft
Veterans skills training services as a result of this funding request?
Male
Female
Unknown/Unreported
Adult Basic Education Completion -
Instructions:
How many veterans does the organization anticipate completing
Veterans adult basic education programs as a result of this funding request?
Male
Female
Unknown/Unreported
16
Instructions:
Completion - Veterans
Male How many veterans does the organization anticipate completing
Soft Skills Training Completion -

Veterans Instructions:
How many veterans does the organization anticipate completing
Male
soft skills training services as a result of this funding request?
Female
Unknown/Unreported
Job Training Credentials - Veterans
Male Instructions:
Female How many veterans does the organization anticipate receiving
Unknown/Unreported credentials/certifications as a result of this funding request?
Part-Time Positions - Veterans Instructions:
Female request, how many veterans does the organization plan to place in
Unknown/Unreported part-time positions?
Full-Time Positions - Veterans Instructions:
Unknown/Unreported fulltime positions?
Internships/Apprenticeships - Instructions:
Veterans Of those who will complete training as a result of this funding
Male request, how many veterans does the organization plan to place as
Female interns or apprentices?
Unknown/Unreported
Self-Employed/Entrepreneur - Instructions:
Veterans Of those who will complete training as a result of this funding
Male request, how many veterans does the organization anticipate
Female becoming self-employed or entrepreneurs?
Unknown/Unreported
Temporary Employment - Veterans Instructions:
Unknown/Unreported temporary employment positions?
Wrap-Around Services - Veterans
(Checkbox List)
WIC
SNAP
Childcare Instructions:
Mental Health Services Please check all additional services that may be provided to
Financial Literacy veterans receiving job training services as a result of this funding
Transportation request.
Housing Assistance
Emergency Food Supply
Earned Income Tax Credit
Donor Recognition
Please review the link below titled ognition Best Practices." Provide the information below to
Rec
describe your donor recognition plan, hould your proposal be selected to receive funding.
17
Although corporations are not

permitted , by law, to receive 'tangible benefits' as a result of their
philanthropic giving, it is a best to receive 'intangible benefits' in the form of reputational
practice
marketing resulting from donor ion.
recognit
R ecognition Best Practices
Instructions:
*Donor Recognition plan Describe how (if selected to be funded) support from the Walmart
(Paragraph)(2000 character maximum) Foundation, the program, and its progress and results will be
communicated and with whom.
Additional Information
Instructions:
*Other Potential Funders
(Paragraph)(2000 character maximum) List other potential funders and the requested level of support for
the proposed program.
*IRS 990 Form Instructions:
(File Upload)File Upload Attach a copy of the organization's most recent IRS 990 form.
*IRS Determination Letter Instructions:
(File Upload)File Upload Attach a copy of the organization's IRS Determination Letter.
Instructions:
*Board of Directors
(User-Defined List) Enter the name of each board member one at a time and click the
"Add to List" button after each entry.
Instructions:
Associate Involvement
(Paragraph)(2000 character maximum) List any Walmart or Sams Club associates that currently serve on
the organization's board of directors.
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State Giving Program Application Example

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State Giving Program Application Example

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Walmart Foundation State Giving Application Preview

*Program Title Instructions:

*Program Focus Category

*Program Subcategory Instructions:

Focus Category value you selected in the Program Focus Category

*Unmet Need/Problem Statement Instructions:

of domestic violence in their

One of the most difficult aspects of

Waypoint is an organization in Cedar

housing. Transportation generally

transportation assistance supporting

counties this past fiscal year as well

Waypoint is a non-profit agency

*Primary Target Population Instructions:

This financial assistance could help

What state is this request for? Instructions:

helping victims pay for bus tickets,

continue after the funding ceases

*P rogram Budget Items Instructions:

If the organization is not requesting support for Personnel Costs,

*Explanation of Materials and Supplies Example:

If the organization is not requesting support for Materials and

*Explanation of Other Direct Costs Example:

If the organization is not requesting support for Other Direct

*Explanation of Indirect Costs Instructions:

If the organization is not requesting support for Indirect Costs,

Number of people served Instructions:

Soft Skills Training Completion -

Although corporations are not

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