Illinois Department of Human Services
Division of Family and Community Services
Bureau of Domestic Violence and Sexual Assault

Domestic Violence Shelter & Services RFA

Released March 12, 2014

Application Content Checklist

Name of RFA:

Applicant Name:

The Application should contain the following in this order:

  • Application Cover Sheet (Attachment A of this RFA) and Tax-exemption Documentation
  • This APPLICATION CONTENT CHECKLIST (Attachment B of this RFA)
  • Executive Summary
  • Agency History and Purpose
  • Provider Program Description and Eligibility
  • Service Delivery
  • Community Needs
  • Data and Demographics
  • Program Evaluation and Auditing
  • Problems and Challenges
  • Staffing Requirements
  • Completed Data and Demographics Form (included as Attachment D)
  • Completed Logic Model Worksheet (included as Attachment E)
  • Completed Budget and Narrative (included as Attachment F)
  • Appendix A: Completed Service Area Description
  • Appendix B: Required 40 Hour Training Certificates; Illinois Certified Domestic Violence Professional Certificates; and DV Program Organizational Chart
  • Appendix C: Agency Organizational Chart
  • Appendix D: Audited Financial Statements