Example: Number of substance counseling sessions to beneficiaries. Example: 120 sessions Goals and Anticipated Outcomes First enter goals that align with and are related to the Proposed Project in the Goals column. For example, if the goal is to “clients completing the Veterans Court program will have their criminal charges dropped.” Then provide the anticipated outcome for the goal listed in the “Anticipated Outcomes” column. For example, “85% of clients will complete the Veterans program.” Additional lines may be added. Goals Anticipated Outcomes Example: Clients completing the Veterans program will have their criminal charges dropped. Example: 85% of clients will complete the Veterans Court program. Next, describe how you will determine if anticipated outcomes are met. Examples may include using a client satisfaction survey, following up with clients 30-90 days after receiving services to determine status, tracking pertinent client data. Project Eligibility Eligibility to receive services must be verified and documented. The RFA includes a list of specific your organization staff may use to verify eligibility of clients who can receive services and ensure that it is applicable to beneficiary definitions above in Beneficiaries #1 (Veteran, dependent, surviving spouse related) and #2 (any other applicable eligibility requirements). Select the forms your agency will use to verify eligibility. DD Form 214, Certificate of Release or Discharge from Active Duty NGB-22, National Guard Report of Separation and Record of Service NA Form 13038, Certification of Military Service Department of Veterans Affairs (VA) official letter or disability letter with character of service listed E-Benefits summary letter with character of service listed Honorable discharge certificate Uniform Services Identification Card State of Texas Issued Driver License with Veteran designation If dependents and surviving spouses are listed as eligible beneficiaries, include how their eligibility will be verified. Select the forms your agency will use to verify eligibility Dependents: Uniform Services Identification Card Marriage Certificate Birth Certificate Adoption Certificate Surviving Spouse:
Following each table, a narrative description supporting and discussing each budget item must be entered, as well as a calculation demonstrating how the cost was arrived at. For example, if there is travel in the budget, the narrative must discuss travel and the appropriateness of travel to the project, and the narrative must include calculations to support how the cost was determined. Costs claimed as direct costs that appear indirect in nature or budgets claiming no indirect costs will be scrutinized for accuracy. Any such costs claimed as direct need to be fully explained, supported, be reasonable and treated in a consistent manner across your organization. The FVA may ask the applicant to re-classify costs as indirect if the support provided does not meet the above criterion. All tables should be rounded to the nearest whole dollar. Do not leave a table blank. Place an “N/A” in the first line and a “0” in Total for the table if you are not budgeting those cost in this application. DIRECT COSTS Salaries and Wages Enter each employee that will be directly associated with the Proposed Project. Enter their position title, employee name, percent of time to be allotted to the Project, and employee’s annual salary rate. Table A Position Title Employee Name Annual Salary % of Time Allocated to the Grant Cost $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ Total Table A $ Describe the responsibilities, and qualifications including any required license or certification of each of the positions listed under Salaries and Wages and how each of those roles are necessary to accomplishing the Proposed Project. Positions allocated 10% or less must be justified as directly working on the grant. Narrative must also include a calculation to demonstrate how the cost was determined. Fringe Benefits For each Position listed in Table A, include the annual fringe benefits for that position. Table B Position Title Employee Name Annual Fringe Benefits % of Time Allocated to the Grant Cost $ % $ $ % $ $ % $ $ % $ $ % $