Board Member Name*

Name of Organization Applying *

Organizational Support (Skin in the game)

Objective: Assess organizational commitment to implement the process.

Definition: Organization has committed to the timely implementation of services, and to provide resources required for implementation (i.e. technology, space, supplies, etc.).

Score (1-5) *

Organizational Need - High Risk Population)

Objective: (NOT REQUIRED FOR SCHOLARSHIP APPROVAL - counted only if relevant) Assess organization’s emphasis on serving populations with heightened risk factor.

Definition: Organization provides services to high-risk and vulnerable populations. (i.e. food, shelter, anti-trafficking, clean water, children and adults living in poverty, church planters in significantly unreached/unengaged regions, etc.).

Score (1-5)

Organizational Need (Underfunded)

Org must fit criteria of underfunded OR underserved, or both to be considered for approval.

Objective: Assess level of need for funding support.

Definition: An organization is considered underfunded if any of the following criteria are met: 1) has experienced significant budget cuts from previous year; 2) experienced loss of key staff member; 3) can demonstrate other financial need.

Score (1-5) *

Organizational Need (Underserved)

Objective: Assess level of attention and support needed.

Definition: An organization is considered underserved if any of following criteria are met: 1) has historically designated little funding for professional development; 2) does not have personnel trained in Integrus processes; 3) has started implementing Integrus processes but needs additional help/resources; 4) organization is newly established.

Score (1-5) *

Leader Support (Buy-in)

Objective: Assess leader statement for personal commitment to implement the process.

Definition: Leader personally advocating and supporting the integration of the proposed training or product solution and demonstrating a commitment to follow-through.

Score (1-5) *

Total Score *

Please enter the total score (min. of 14 required for scholarship consideration; this score doesn't require a recommendation for approval, but all applications recommended for approval should have a min. score of 14)

Were other supporting documents provided by the applicant? (NOT required)

Recommendation

Electronic Signature *

By entering my name, I confirm, to the best of my knowledge, that the information I have entered is true, and I am making the above recommendation on behalf of the Integrus Foundation Board of Directors.