2024-2025 Sustaining Fund Application

Camp Name:*

Please provide the mission statement of your camp:*

Please list your camp's website:*

Number of Campers Expected

For 2024:*

For 2025:*

Number of Volunteers Expected

For 2024:*

For 2025:*

Medical Team Staffing

# of Medical Team Staff for 2024*

# of Medical Team Staff for 2025*

Please describe the makeup of your medical team (# of physicians, nurses, PA's, etc., include social support as well - child-life specialists, social work, TR's) and also what hosptial(s)/sources the medical team members are coming from (Cook, SRH, Children's, outside sources):*

Additional Funding

Are you currently raising funds for your camp expenses?*

Please state how the funds are being raised, the amount raised, and the proposed use of these funds:

Are any costs/fees/deposits passed on or charged to campers/families, volunteers, and/or staff?*

Tell us about these costs/fees/deposits (who are they passed to, how much, for what purpose, etc.):

Are you the recipient of any grants, corporate gifts, and/or individual annual gift?*

Please state the source, amount received, and how funds will be used:

Please provide a statement discussing how camp will continue to be funded after/upon Camp John Marc's funding ceases.*

Please discuss your goals as it pertains to Sustaining Committee Funding (for examples: we believe we will have a continuing need for funding, we plan to decrease funding by X% per year over the next Y years, we feel we will need to apply to the Committee X more times):*

Hospital Partnership

Describe your relationship and partnership with the DFW Pediatric Hospitals?*

What role do these hospital(s) play in the success of your week at camp?*

What is your understanding of the costs associated with the medical team/medical support, supplies, and other resources being provided by the partnering hospitals?*

Evaluation

What criteria have been established to evaluate your program's success?*

Do you have a Strategic Plan? (if yes, please upload a copy below)*

Camp Representative/Officer filling out this request:*

First Last

Email*

Phone*

At the conclusion of each year of this cycle (in 2024 & 2025), I will receive a request for a follow-up report regarding my camp program. This request will occur late fall/early winter.*

I Understand and agree to submitting this report when requested.

2024 Operating Plan/Budget*

Drop files here or

Max. file size: 256 MB.

Current Audit (or Review if you do not perform a full audit annually)*

Max. file size: 256 MB.

Current IRS Form 990*

Max. file size: 256 MB.

List of Board Members and Officers*

Max. file size: 256 MB.

Proof of current 501(c)(3) status*

Max. file size: 256 MB.

Strategic Plan*

Max. file size: 256 MB.

A recent publication, newsletter, or articles featuring your organization*

Max. file size: 256 MB.

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