Greater Carlisle Community Foundation

carlislefoundation.org

Grant Application Overview

Mission Statement:

The mission of the Greater Carlisle Community Foundation is to promote philanthropy thoughout the P.E.A.C.H. communities which include the communities of Palmyra, Easter Lake, Avon, Carlisle and Hartford.

What we support:
The Greater Carlisle Community Foundation makes grant awards to worthwhile projects that are identified through a community grant application process. Our foundation’s areas of emphasis include:

  • Arts & Culture
  • Community Betterment
  • Education
  • Health & Human Services
  • Recreation & Environment
  • Youth Development

Eligibility to Apply for Funding:

Tax exempt, non-profit entities classified by the IRS as 501(c)(3) or a 170(c)(1) unit of government

If not 501(c)(3) or a 170(c) must have a fiscal sponsor who will be legally & financially responsible

One application per organization

Grant request an average in the past has been $250, however more may be requested.

Application Deadline:

The original completed Greater Carlisle Community Foundation Grant Application and 8 copies must be postmarked byMonday, October 5, 2015 and mailed to:

Greater Carlisle Community Foundation

P.O. 430

Carlisle, IA 50047

OR Hand Delivered to the Carlisle City Hall at 195 N 1st Street in Carlisle byOctober 5, 2015.

Greater Carlisle Community Foundation Contact Information:

Pat Brehse, Grant Committee Chairperson

515-419-2383 or

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Follow Grant Instructions

Has your organization received GCCF grant funds in the past?

/

______Yes ______No

If yes; which grants cycle/s ______

/

Amount Awarded ______

Have you met all your conditions of the previous grant agreement

/

____ Yes ____ No

If no, please explain: ______

______

Organization Information

1.

Name of organization

/

Legal name (listed with IRS)

2. / 3.

Organization Address

/

City, State, Zip

/

Employer Identification Number (EIN)

3.

Phone

/ Fax / Web site

Name of contact person regarding this application

/

Phone

/

E-mail

4. Type of funding support (circle one):

/

Capital Based

/

Program Based

5. Project focus area that primarily applies

(circle one):

/

Arts, Culture & Humanities

/

Education

/

Environment & Animals

Health

/

Human Services

/

Public & Society Benefit

6.is your organization an IRS 501(c) (3) not-for-profit?

/ Yes / No

If no, is your organization a 170(b) unit of government?

/ Yes / No
If no, you must have a fiscal sponsor. List the fiscal sponsor name, contact person and the contact person's name, title, address,
telephone number and e-mail address:

Fiscal Sponsor’s EIN number

7. Describe your organization’s charitable purpose, program activities, and population demographics (age groups served, primary area served) (4-5 sentences)

Application

Request Summary

8. Name of the Project: ______
9. Describe the proposed project, including the goals and objectives. Discuss the community need for the project, the benefits for the community as a result of the project and the community support for the project.
10. Summary of Project (3-5 Sentences):

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11. Project population
Served (estimated #)
12. Total project cost: / $ / 14. Total requested from the Community Foundation: / $
13. Amount of matching funds: / $ / 15. What percentage of total funds is matching dollars?
(Matching $ ÷ Total Project $ x 100 = % of funds match) / %
16. Outline how grant funds will be used and identify other resources or partners identified to assist with the project; other funding secured, applied for and proposed for the project. Include how volunteers will be utilized and the number of volunteers expected to participate:
17. Indicate desired impact and how you will measure and evaluate the results of the project. Be specific regarding community needs/issues your project will address. How will contributions from the Greater Carlisle Community Foundation be recognized?
18. What is the timeline for this project? Projects must be complete within one year.

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Project Budget

Budget Form

19. Attachments are required: Letter(s) of commitment for in-kind contributions and other funding sources matching your request, estimates

or bids, and an organizational budget. Please note: Section A=Sections B+C+D.

A /
TOTAL PROJECT COSTS FOR THE GRANT
(Itemize specific expenses below and provide dollar amount.)
# / Item / Amount ($)
1
2
3
4
5
6
Total Cost of Project
B /
IN-KIND CONTRIBUTIONS
(Itemize below and estimate dollar amount. Please attach letter(s) of commitment.Volunteer hours must not be included as an in-kind contribution.)
# / Item / Amount ($)
1
2
3
4
5
Total In-Kind Contributions
C /
FUNDING FROM SOURCES OTHER THAN THIS GRANT
(Itemize below and estimate dollar amount. Please attach letter(s) of commitment.)
# / Item / Amount ($)
1
2
3
4
Total from sources other than this grant
D /
TOTAL COST OF GRANT EXPENDITURES (TOTAL REQUESTED FROM GCCF)
(Itemize specific expenses below and provide dollar amount.)
# /

Item

/ Amount ($)
1
2
3
4
Total Amount Requested From GCCF

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20. In order to be considered for funding, your application MUST include ALLthe following items:

_____ Review Grant application instructions & frequently asked questions.

_____ Complete orginal signed grant application (including balanced Project Budget sheet) plus 6 copies of application and all supportig documents.

_____ Letters of commitment for any funds outside of grant (see Project Budget page of application)

_____ Signed applicant Board Approval Agreement (see below)

_____ All additional documentation should be placed behind last page of the rant application.

_____ Copy of latest Federal IRS Tax-exempt status letter.

_____ Signed ‘Letter of Intent’ to act as a fiscal sponsor if applicable – ONLY if you are not a section 501©(3) or a section

170 organization.

_____ Estimate(s) Quotes(s) for materais of services. If estimites are from websites, the unit price and total price must be clearly marked and/or high – lighted.

_____ Organizational Budget (if the organization serves more than Greater Carlisle Community Foundation area (Avon, Carlisle, Easter Lake, Hartford and Palmyra), a breakdown budget for our area is requested.

_____ List of Board of Directors and their affilations.

______

Board Approval from Applicant Organization:

______approve submission of this grant request and certify that the purpose of this

(Name of Organization)

request is charitable and that monies received from the Greater Carlisle Community Foundation will be used solely for the project stated in this application.

Authorized agent/ title / Date

For GCCF use only:

Grant Committee Determination: / Amount
Approved / Denied / Date
Board of Directors Determination: / Amount
Approved / Denied / Date

This application has been approved in the amount of $ ______on (date) ______.

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