SAGES Education & Research Foundation Grant Application - SAGES Education and Research Foundation

Are you submitting a grant for a SAGES Committee?*
- Yes
- No
The SAGES Education & Research Foundation awards grants that help to advance its vision of a healthcare world in which all operative procedures are accomplished with the least possible physical trauma, discomfort, and loss of productive time for the patient.

The overarching goal of the Foundation is to advance laparoscopic, endoscopic, and other minimal access surgical methods by supporting reproducible scientific research and outcome studies, graduate and postgraduate education, and public information.

Any 501(c)3 or 501(c)6 organizations that align with the vision and goal of the Foundation are eligible to apply for grants. Awards are conferred on a competitive basis by submission of a grant application, which is reviewed and evaluated by the Foundation’s Grants Committee and approved by the Board of Directors. Awards are granted for one year projects and investigators may apply for renewal funding.

Availability of Grants: The Foundation will consider grant applications of $1,000 to $100,000.

Deadline:
Grant applications must be submitted by 5:00 p.m. (Pacific Time) on Monday, September 9, 2019 for funding consideration for the following calendar year. Any application received after 5:00 p.m. (Pacific Time) on September 9, 2019 will not be considered.

General Instructions & Guidelines:
It is assumed that some of the resources required to conduct the project are available through the applying institution. The grant funding will provide supplemental support for personnel, equipment, or services required for project completion.

Awards are based on the educational and/or scientific merit of the project, the project director’s capability, and the likelihood that the project will be completed successfully.

The application questions reflect the interests of the SAGES Foundation, but are not intended to be conclusive. Answers should be concise but thorough.

Progress Reports:
If a grant is awarded, all payments are contingent upon a satisfactory progress report of said activities. The progress report must be submitted upon completion of the funded project, or no later than 6 months from the date funding was received, whichever comes first. A progress report template will be provided to all funded applicants.

A. NARRATIVE
1. Organization
Organizational information:*
Organization's history:*
Organization’s mission and goals, long-range plans:*
Outline current programs and activities:*
Major Accomplishments:*
The SAGES Education & Research Foundation awards grants that help to advance the mission of the Foundation. *This is an abbreviated form to be used by SAGES Committees to apply for funds.

Availability of Grants: The Foundation will consider grant applications of $1,000 to $100,000.

Deadline:
The deadline for submission is 5:00 p.m. (Pacific Time) on Monday, September 9, 2019 and funding will start after January 1 of the following year. All applications should be submitted by the deadline. Please note: the Grant Review Committee will not accept proposals submitted after the deadline.

Progress Reports:
All future payments are contingent upon a satisfactory progress report. Progress reports must be submitted by July 31 of the funding year. Note: If your project was awarded a grant from the SAGES Foundation in the past, your current application will not be considered until a progress report from the previously awarded grant is received.

General Instructions & Guidelines:
Please structure your proposal to provide the following information.

A. NARRATIVE
1. Purpose of Grant/ Project Description
2. Purpose of Grant/ Project Description
Describe the proposed program or project:*
Identify the needs to be addressed, number of people to be served by the project:*
Project goals and objectives:*
Timetable for implementation:*
Evaluation: Describe the plan to document progress and results. Provide specific, detailed metrics to show effectiveness and/or success of project.*
2. Project Director/Project Managements/Committee
Specify if the project is a new or continuing program:*
Identify other organizations, partners, or funding agencies participating in the project:*
3. Principal Investigator, Project Management, Venue
Name the principle investigator (if the project is research oriented) and list their qualifications:*
Name the project manager and list their qualifications:*
Name any additional professionals participating in the project management or operations:*
Where will the program/project be actualized? Provide qualifications of the institution or venue (if different from the organization):*
Evaluation - Describe the plan to document progress and results. Plan should delineate the metrics used for evaluation. Final evaluation and expenditure reports will be required for each grant awarded:*
Name the Project Director and his/her academic institution:*
Name any additional committee members or SAGES members participating in the project:*
B.ATTACHMENTS
1.Project budget including:
- Travel
- Equipment, hardware, software
- Supplies and materials
- Printing and copying
- Telephone and fax
- Postage and delivery
- Project Management fees
2. Income-Include all confirmed and anticipated sources of revenue and indicate status. Provide an income total.
- Other foundation grants
- Corporate or individual donations or grants
- Project income, sales or fees
- In-kind support
SAGES Education & Research Foundation Grant Application Cover Sheet
B.ATTACHMENTS
Please include the following attachments:
1. Copy of the current IRS determination letter indicating 501(c)(3) or 501(c)(6) tax-exempt status
2. Organizational structure, including:
- List of officers and directors, including academic or professional affiliations
- Description of committees and task forces
- Resumes and/or job description of key personnel involved in the project
3. Financial information, including:
- Project budget; refer to the Grant Application Budget Outline attached
- List of other funding agencies and potential funding sources and amounts committed or requested individual contributions and other sources of income supporting the project
- Current board-approved annual operating budget for the organization or department
- Most recent annual financial statement
4. Optional-Letters of support that substantiate need for the project and collaboration with other organizations

GRANT APPLICATION BUDGET OUTLINE
An accurate, detailed budget for proposed projects is required.

Please break down the total budget into the specified items listed below. A narrative description explaining unusual budget items and, if applicable, the percentage of "overhead" applied to the project should precede the itemized listing. "In-kind" expenses and donations or matching funds should also be described. As long as the application contains the following information, it can be submitted in any format (word, excel, pdf, etc.).

A. HEADING
Please specify the budget period, e.g., calendar year (Jan. – Dec.) or fiscal year (July – June)

B. EXPENSES
Please itemize the following expenses and include any additional items relevant to your particular project. Provide an expense total.
- Salaries and wages by individual position, specifying full- or part-time positions
- Payroll taxes
- Fringe benefits and related fees
- Consultant and professional fees, e.g., accounting, legal, etc.
- Travel
- Equipment, hardware, software
- Supplies and materials
- Printing and copying
- Telephone and fax
- Postage and delivery
- In-kind expenses
- Project overhead (the Foundation allows up to 15%)
TOTAL EXPENSES:

C. INCOME
Please include all confirmed and anticipated sources of revenue, and indicate their status. Provide an income total.
- Government grants and contracts
- Other Foundation grants
- Corporate or individual donations or grants
- Project income, sales or fees
- In-kind support
- Other revenue
TOTAL INCOME:

SAGES Education & Research Foundation Grant Application Cover Sheet
Date of Application:*
Date Format: MM slash DD slash YYYY
Name of SAGES Committee Applying:*
SAGES Committee Chair:*
SAGES Committee Chair E-mail:*
Legal Name of Organization Applying:*
Should be the same as on IRS determination letter and as supplied on IRS Form 900
First Middle Last Title
Year Founded:*
Current Annual Operating Budget:*
Executive Director:*
Executive Director E-mail:*
Contact Person/ Title (if different from Executive Director):
First Middle Last Title
Principle Investigator/ Project Coordinator:*
First Last
Principal Investigator/Project Coordinator E-mail:*
Address (Principal/Administrative Office):*
Mailing Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Website:*
Project Name:*
Purpose of Grant (one sentence):*
Beginning and Ending Dates of the Project:*
Amount Requested:*
Total Project Cost:*
Geographic Area Served:*
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SAGES Education & Research Foundation Grant Application Cover Sheet

SAGES Education & Research Foundation Grant Application Cover Sheet