2017 Colorado Corn 4-H Grant Program

Agriculture Education Programs

Request Form

Please send completed form by email only to by December16, 2016. Limit application length to 5 pages or less (excluding budget page).

This grant is funded by Colorado Corn for creating new or expanding current 4-H programs related to agriculture education. The Board is dedicated to allocating funds for high impact youth development programming. This application is for programs, events and activities held January 1, 2017 through December 31, 2017.

Program Name:

Submitted by:

  1. Name:
  2. Address:
  3. City
  4. Zip:
  5. Telephone:
  6. Email Address:

Program Description: Pleaseanswer the following questions. Please remember not all board members are familiar with all aspects of the 4-H youth development program. A good program description helps the board understand the program and helps them explain it to potential donors.

  1. When and where will the program occur:
  2. Number of people involved: ______youth ______adult volunteers
  3. What will participants do
  4. How does this program further youth and/or volunteer development?
  5. What are the projected outcomes and impacts?
  6. Is this a new program? _____ yes _____ no
  7. If yes, please explain the need:
  8. Is this an ongoing program: _____yes _____ no
  9. Discuss the current enrollment trends, changes in the program and other factors that support new funding.

Grant Amount Requested($5,000 maximum): ______

  1. Would you accept a lesser amount _____ yes _____no

(Requests will be not be reduced by more than 50%)

Budget & Narrative

1.Budget:please use the excel budget template found on the grants website and email it to

2.Budget Narrative: (please answer the following questions.)

  1. Total estimated cost of the program:
  2. Other income sources: (please explain)
  3. Registration Fees:
  4. Sponsorships:
  5. Other grants:
  6. Other sources:
  7. Does your county have a 4-H Foundation? _____ yes _____no
  8. If yes, have you requested funding from them for this program? _____ yes _____ no
  9. If yes, what was their response? Click here to enter text.
  10. What specific costs will be covered by this grant? Click here to enter text.

Evaluation:

  1. How will this program be evaluated?
  2. What indicators of success will be monitored and measured?

Additional Information: Please provide any additional information that will help the 4-H Foundation board appropriately consider this proposal.

By submitting this grant request, the person whose name appears below certifies this 4-H youth development program has been planned and designed with the appropriate involvement of volunteers, youth and Extension professionals, has the full support of their Program Leader, and will be conducted according to Colorado Extension policies and procedures.

Furthermore, the requestor acknowledges granted funds are to be used for the purposes described above unless prior approval is received, and agree to provide a written financial and program summary to the Colorado 4-H Foundation within 45 days of completion of the grant request period. Photos and quotes are helpful for the Colorado 4-H Foundation annual report and notes to donors.

Completed by: ______Date: ______