NAVAJO NATION –CHAPTER/COMMUNITY CONTRIBUTIONS

GUIDELINES

USE OF THIS APPLICATION

This application is for use to request contributions from Cyprus Amax Minerals Co. (“Cyprus”) or Western Nuclear Inc. (“Western Nuclear”)to support local tribal activities.

  • Each request should be for no more than $3,000 each (per project/activity)
  • Most contributions awarded will be between $250 and $1,000 each
  • No more than $5,000 in total will be awarded to a Chapter/Community each year

APPLICATION DEADLINES

Applications are accepted on a rolling basis. Applications require at least four weeks to review. You will be notified of your award status 30 days after the application is submitted.

APPLICATION SUBMISSION

Applications should be completed and saved as a Microsoft Word document and submitted via email to Tanayia White at nd/or Peter Denetclaw at .

PROJECT/ACTIVITY ELIGIBILITY

It is our aim to support organizations, programs and projects.Theseshould target a specific issue or need. Examples ofidentified priority issues or needs areEducation & Training, Health & Wellness,Cultural Preservation,Economic Development , and/orElders.

The above specific issues or needs should focus on benefiting the Chapter/Community members and not individual needs or needs benefiting a few.

USE OF GRANT FUNDS – Funds will not be awarded to the following:

  • Organizations that do not have 501c-3 or other non-profit status as designated by the IRS. (Note: governmental/tribal offices or agencies are qualified as long as the project or activity is eligible as outlined in these guidelines).
  • Foundations that intend to re-grant the funds
  • Requests for individuals, including those for travel support, teams that are restrictive in participation or anything else that benefits a single individual or a very limited number of individuals
  • Advertising efforts
  • Fraternal, labor or veteran organizations/activities limited to organization membership
  • Religious activities, churches or church sponsored activities limited to church membership
  • Political or lobbying activities
  • Organizations that discriminate on the basis of race, sex, religion, national origin, age, disability, or veteran status

QUESTIONS

For more information on the guidelines, application or the process to submit the application via email, please contact Tanayia White at 602-376-7242 or .

NAVAJO NATION – CHAPTER/COMMUNITY CONTRIBUTIONS

APPLICATION

IMPORTANT NOTES:

Your Application should not exceed two pages. This is page 1.

Please be sure to complete each question. Incomplete questions may cause an application to be ineligible.

ORGANIZATIONAL OVERVIEW

Name of Navajo Chapter:
Name of Organization or Department:
Name / Title of main contact person:
Phone number:
Email address:
Mailing address:
Organization website (if available):
Total (annual) organization budget:
Name of project or activity:
Grant amount requested:
($250 - $1,000; no more than $3,000 can be requested through this application program)
Total project / activity budget:
Project or activity START date:
Project or activity END date:
Check the Focus Area / Category
For which You Are Applying: / Does your project address a special population?
Education & Training
Health & Wellness
Cultural Preservation
______Economic Development
Elders / Women and Children
Other (please list):
Briefly summarize the proposed project or activity, the clients it will serve and its major objectives.
Please limit your response to no more than 5 – 7 sentences.

Navajo Nation – Chapter/Community Application / Page 2

Please describe the need addressed by your project or activity, and desired outcome.
Please describe how the requested funds will be used? If funds will be used to purchase items/materials, please describe.Please also include a simple budget detailing how funds will be used).
Please list any other partners in this project / activity who are providing funds or other resources.

Please be sure to include support documentation and sign the Statement of Understanding.

See LAST PAGE of this document.

Support DocumentationRequired (please check the boxes to ensure these items are attached)

Copy of 501c-3 status letter from the IRS or Related Certification

Detailed Project Budget (including other sources of funding/income)

Supporting Chapter Resolution (if applicable)

Please return this application (and attachments) via e-mail:

Via e-mail:

Peter Denetclaw

Manager Envir Programs & Navajo Relations

Tanayia White

Native American Affairs

STATEMENT OF UNDERSTANDING

If awarded, grant funds must be used for developing and implementing the project as described in the award letter received at time of funding.

Signature:

Date: