THE LEIGHTY FOUNDATION

2013 GRANT APPLICATION SUMMARY

THIS FORM MUST ACCOMPANY YOUR GRANT REQUEST AS THE COVER PAGE

Please email completed forms to:

DATE:

ORGANIZATION:

MAILING ADDRESS:

PROGRAM NAME (IF APPLICABLE):

CONTACT PERSON:

PHONE: EXT: BUSINESS CELL PHONE:

E-MAIL:

WEBSITE:

MISSION STATEMENT OF ORGANIZATION:

PURPOSE OF GRANT:

TOTAL PROGRAM COST:AMOUNT REQUESTED:

FISCAL YEAR END:

______

Signature of Executive Director Date

______

Print Name of Executive Director

LEIGHTY FOUNDATION OFFICE USE ONLY

Support Type:______

Area of Emphasis: ______

THE LEIGHTY FOUNDATION

2013GRANT APPLICATION

*Since we are a small foundation and board and wish to be personally connected in some way with each of our grantees, we consider only grant proposals that we have solicited. Organizations that have not been invited to submit a proposal should make initial contact throughJill Haubert, Executive Associate, by a one-page letter that includes: the mission of the organization, the need to be addressed, the intended outcome of the endeavor, and the size of the grant requested.

Website: Contact:

PLEASE PROVIDE CONCISE ANSWERS TO THE FOLLOWING QUESTIONS (Preferred length not to exceed 3 pages)

DEADLINE FOR SUBMITTING GRANT PROPOSALS: Monday, May 13, 2013

Some applications are due at other times by specific arrangement with a Leighty Foundation director.

  1. What will your organization accomplish with this funding?
  1. What are your strategies for making this happen?
  1. What are your organization’s unique capabilities for doing this?
  1. How will your organization evaluate the impact you are making? How will project results be used and disseminated?
  1. Describe how your organization involves volunteers to increase the impact of your mission. Who manages the infrastructure which supports your volunteer resources?
  1. What recent changes have you made in your operations, budgeting, or mission to become more efficient, and less demanding of Earth’s resources?
  1. Describe new challenges and opportunities you predict the organization might face in the next three to five years and how you plan to respond to them.

APPLICATIONS WILL NOT BE CONSIDERED UNTIL ALL OF THE FOLLOWING ARE RECEIVED:

We prefer to receive these electronically. If that is not possible, send hardcopy to PO Box 37, Cascade CO 80809

_____IRS Letter of Tax Exemption 501(c)(3)

_____ Grant Application Summary, Application, and Program Budget (if applicable)

_____ Current Balance Sheet

_____ Current FY Actual and Board approved Income & Expense Statement

_____ Current List of Board of Directors

_____ Representative List of Contributors

THE LEIGHTY FOUNDATION

2013 PROGRAM BUDGET

Complete this form only if you are applying for a Program/Project Grant.

Organization Name:

Program Name:

Itemized Program Expenses:

______$______

______$______

______$______

______$______

______$______

______$______

______$______

______$______

______$______

______$______

______$______

Total Cost (A)$______

Funds Currently Committed for Program:

Trustees$______

Corporations$______

Foundations$______

Individuals$______

Government$______

Other (earned income, special events$______

Membership, subscriptions, etc.)

Total Funds Available (B)$______

Balance Required (A minus B)$______

Amount Requested$______

Revised Jan 2013Page 1 of 3