Download Attachment C – Logic Model Template

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Attachment C - Logic Model
Instructions
Complete the Logic Model using the below information and example as a guide. Please add items as appropriate and relevant to your program, not to exceed
three (3) pages and no less than 10 point font size.
The logic model must include the following:
 Inputs (all components that make your program successful, including:)
o Number of locations or sites in which members are providing direct services
o Number of AmeriCorps members that will be delivering the intervention or program model
o Available resources to support the interventions
 Activities
o The core activities that define the intervention or program model that members will be implementing or delivering
o The duration of the intervention (e.g., the total number of weeks, sessions or months of the intervention)
o The dosage of the intervention (e.g., the number of hours per session or sessions per week)
 Outputs/Outcomes
o The indicators that will be used to measure and track program outcomes
Example - Program Name: Healthy Living Corps
Project Resources
Core Project Components
Evidence of Project
Evidence of Change
Implementation and
Participation
INPUTS
ACTIVITIES
OUTPUTS
OUTCOMES
Short-Term
Medium-Term
What we invest
What we do
Direct products from
Changes in
Changes in behavior or
(including # and
program activities
knowledge, skills,
action that result from
type of
attitudes and
participants’ new
AmeriCorps Slots)
opinions
knowledge
- 10 partner Sites - Members will train volunteers for 8 - 100 volunteers trained as - 450 participants
- 350 participants will
- 100 volunteers
hrs/day for 3 days in nutritional
tracked by volunteer log
will have increased
purchase more nutritional
- 20 FT
curricula
- 500 participants
knowledge of
food using a shopping list
AmeriCorps
- Sites will develop ten 1-hour
complete nutritional
healthy eating
as demonstrated by
members
nutritional curricula modules for
course measured by
habits as measured
follow-up survey
- Federal, State,
economically disadvantaged families training sign in sheets
by pre/post test
- 325 participants will
local funding
- Volunteers will teach nutritional
- 150 education events
- 400 participants
improve nutritional
- Research-based courses for 2 hrs/wk for 10 weeks to held measured by event
will demonstrate
practices by purchasing
nutrition
families receiving food assistance
agendas
healthy food
more fruits and
educational
- Members will facilitate 1 hour
- 10 thriving partner
preparation skills as vegetables as
curricula
standalone educational events for
programs measured by
demonstrated by
demonstrated by followdisadvantaged families and teens
partner survey
pre/post test
up survey
1 / Program Logic Model
Long-Term
Meaningful
changes, often in
their condition or
status in life
- 320 participants
will eat healthy
foods as
measured by
follow-up survey
- 300 participants
will provide a
healthy food
environment for
children as
measured by
follow-up survey
Legal Applicant Name:
eGrants Application ID:
Project Resources
Core Project Components
INPUTS
ACTIVITIES
What we invest (# and
type of AmeriCorps
Members
2 / Program Logic Model
What we do
Evidence of Project
Implementation and
Participation
OUTPUTS
Direct products from
program activities
Evidence of Change
Short-Term
Changes in knowledge,
skills, attitudes and
opinions
OUTCOMES
Medium-Term
Changes in behavior or
action that result from
participants’ new
knowledge
Long-Term
Meaningful
changes, often in
their condition or
status in life