Funds Dissemination Committee/Funds application form

ATTENTION This FDC page is out of date, new pages have been created. Please see the FDC portal for all current documents.

This is the application form that all eligible entities need to complete to request funds from the FDC. The completed document must be published on Meta by the application deadline for each round (23:59 UTC 1 October for Round 1, and 23:50 UTC 1 March for Round 2).

Fund-seeking entities should be familiar with the following information:

• application process and timeline
• the roles and responsibilities of fund-seeking organizations
• assessment criteria
• scoring rubric

Basic information

Legal name of affiliated entity	Entity to complete
Contact name and position in entity
Contact username or email
Entity fiscal year (mm/dd–mm/dd)
Timeframe of funds currently requested (mm/dd/yy–mm/dd/yy)
Total annual budget (expenses) of entity (in $US and local currency) for the funds request
Amount requested from the FDC (in $US and local currency)
Amount to be realized from non-FDC sources (in $US and local currency)
If FDC funds were received last year, how much was received last year
Date posted mm/dd/yy1

¹The application is assumed to be final as of the application deadline for each round (October 1 for Round 1 and March 1 for Round 2). After this date, the application must not be further modified; any further commentary should be included on the talk page.

Background, history, and mission

This section provides an overview of your entity's background and history.

• When was your entity established?

• What is the mission of your entity, and how does it support the goals of the Wikimedia movement?

• What is its current leadership structure (e.g., executive staff structure, board / governance structure)?

• How many staff are employed by your entity?

• Approximately how many active volunteers participate in your entity?

• How many members comprise your entity?

Past activities and innovations

This section provides the FDC information about your entity's past activities and strategies. Please give links to the following.

• Previous completed fiscal year annual plan

• Previous completed fiscal year annual report

• Previous completed fiscal year grant report (if your entity has received funds from the FDC)

• How does your entity define and measure "success"?

• Give at least three examples of successful activities your entity has completed

• What did not work? What did your entity learn from that experience / those experiences?

• What else has your entity learned or innovated on that could benefit the broader Wikimedia movement?

Year-to-date progress

Provide information about how your entity is progressing against the current year's projected budget (revenues and costs). If it would be helpful, link to your entity's current annual plan and budget.

• Year-to-date funding from all sources

• Expected

• Actually received

• Year-to-date spending

• Planned

• Actual

• If year-to-date funding or spending are significantly different from what was planned or expected at this point in the year, provide a detailed explanation.

Key initiatives and objectives of the annual plan for which funding is sought

Key initiatives	What are the objectives of this initiative (include metrics)?	Which Wikimedia strategic goal(s) does this initiative address?	What key activities / milestones are associated with this initiative?	How will your entity accomplish this initiative?	How will your entity measure and track the success of this initiative?
Example: Editor conference	Increase retention of editors by XX% from previous year Create XX new articles	"Increase global participation" "Expand reach"	Begin seeking external funders by February 2013 Plan event logistics March–April 2013 Execute event in May 2013 Follow-up survey and tracking of indicators	2 staff members partially allocated to planning this event Core volunteer base, many who have planned this event in the past	Track number of editors each month throughout the year Track number of articles created each month throughout the year
...	...	...	...	...	...

Additional context for the annual plan for which funding is sought

This is where any residual case for meeting the assessment criteria should be made, if not covered in the previous section.

• What organizational strengths enable your entity's plan (e.g., leadership, community participation, fundraising)?

• What external opportunities enable your entity's plan (e.g., socio-political context, community participation, fundraising)?

• What are key risks or threats that would prevent you from achieving the plan (e.g., socio-political context, community participation, fundraising)?

• How will you minimize these risks?

Financials for the annual plan for which funding is sought

• Provide a detailed budget or outline costs in the format below. (If you have a link to a detailed budget elsewhere, include the link and ensure all of the information outlined below is included in that link.)

• Annual plan information and funds request should be in both $US and local currency, using a consistent exchange rate.

• Assumed exchange rate throughout:

Revenues

Revenues	Anticipated (local currency)	Anticipated ($US)
e.g., FDC grant	$50,000	$50,000
e.g., Other grants	$100,000	$95,000
e.g., Other (corporate sponsorship, member dues)	$5,000	$10,000
Total revenues	$155,000	$155,000

Current organizational staff (e.g., included in year-in-progress budget)

Function	Staffing (full- and part-time)2	Total annual salary (local currency)	Total salaries ($US)
e.g., Finance	1.0 + 0.6	$50,000	$50,000
Total operating staff expenses		$50,000	$50,000

²For full-time staff, enter 1.0; for part-time staff enter portion of full-time (e.g., 0.25, 0.5)

Proposed new staff for the annual plan for which funding is sought

Function	Staffing (part- and full-time)3	Total annual salary (local currency)	Total salaries ($US)	Duration	Rationale for hiring new staff
e.g., Finance	0.8 + 0.4	$50,000	$50,000	Temporary (< 1 year); short-term (< 5 years); long-term (5+ years)	e.g., need to enhance finance system
Total new staff expenses		$50,000	$50,000	–	–

³For full-time staff, enter 1.0; for part-time staff enter portion of full-time (e.g., 0.25, 0.5)

Non-staff operating expenses

Operating expenses	Amount requested (local currency)	Amount requested ($US)
e.g., Infrastructure (rent, utilities, servers)	$10,000	$10,000
e.g., Office expenses (office supplies)	$10,000	$10,000
e.g., External costs (accounting, consulting)	$10,000	$10,000
Total operating expenses	$30,000	$30,000

Other costs not included above, e.g., for specific one-time projects

Initiative	Amount requested (local currency)	Amount requested ($US)
e.g., Spring conference	$100,000	$100,000
Total project costs	$100,000	$100,000

Verification that no funds will support political or legislative activities

The term “political or legislative activities” includes any activities relating to political campaigns or candidates (including the contribution of funds and the publication of position statements relating to political campaigns or candidates); voter registration activities; meetings with or submissions and petitions to government executives, ministers, officers or agencies on political or policy issues; and any other activities seeking government intervention or policy implementation (like “lobbying”), whether directed toward the government or the community or public at large. Grants for such activities (when permitted under U.S. law and IRS regulations) should be sought from the GAC.

I verify that no funds requested from the FDC will support political or legislative activities

Yes/No