33 W. 10th St., Suite 600

Anderson, IN 46016

2017Youth Leadership Academy Grant

APPLICATION COVER SHEET

Designed to benefit the youth of Madison County, the Youth Leadership Academy Grant Cycleis open to any Madison County nonprofit organization which oversees programming benefitting young people. Applications will be reviewed and awards made by the participants of the Youth Leadership Academy (YLA). The YLA consists of high school juniors from varied economic backgrounds, academic standings, race, and ethnicity, who come together to gain knowledge and ownership as conscientious community stewards.YLA Grant requests should be between $250 and $1,000.

INSTRUCTIONS: Please include one original and 6 stapled copies of this completed Cover Sheet, responses to the Grant Application Questions, and the completed Project Budget. Include one copy only of the organization’s most recent audit or financial statement, a current listing of the Board of Directors, and a copy of your IRS determination letter. Application deadline is4p.m., Thursday, February 22, 2018. Incomplete or late applications will necessarily be rejected. Please direct any questions to Kari Sisk, Program Directorat r 765.644.0002.

Submit your request to:

Madison County Community Foundation

Attn: Youth Leadership Academy

33 W. Tenth St., Suite 600

Anderson, IN 46016

Organization Name:

Mailing Address:

Contact Person:

Title:

Telephone:

Email Address:

Website:

Date of Incorporation:

IRS Status:

Federal ID#:

Requested Grant Amount:Total Project Amount:

Project to Begin: Project to End:

Title of Project:

Brief Project Description:

Signature of Chief Executive Officer: ______

Name and Title of Chief Executive Officer:

2017Youth Leadership Academy Grant

APPLICATION QUESTIONS

INSTRUCTIONS: Please limit your narrative responses to a maximum of 2 pages in total.

  1. Program Objective:
  1. Financial Need:
  1. Program Justification:
  1. Constituency:
  1. Evaluation Plan:
  1. Community Impact:
  1. Additional and Future Funding:
  1. Professional References:
  1. Collaborative Value:

2017Youth Leadership Academy Grant Project Budget

The categories developed on this worksheet are meant to be a guideline. You are welcome to change the line items so they are meaningful to your project. If possible, MCCF would still prefer you use this form for your budget.

Approved awards are based solely on line items included in this proposal. You may not spend the MCCF grant on any expenses not listed here without a formal, written addendum approved prior to the expenditure. Additionally, you may not use grant funding to reimburse your agency for expenditures that occur prior to your award approval date.

MCCF generally will not fund annual campaigns, rent or utilities, capital debt reduction, gifts to endowments, travel grants, or programs/equipment that were committed prior to the application being submitted.

Project Expenses- list expense items for this project in the table below:

Expense Items / Amt. requested of
YLA / Amt. from other sources / In-Kind Donations / Total
Salaries/Benefits
Travel
Equipment
Supplies
Printing/Copying
Postage/Shipping
Maintenance/Repairs
Training
Marketing
Other (Specify)
Total Project Expense