2013-14

Minnesota Timberwolves FastBreak Foundation

Grant Application Form

“The Minnesota Timberwolves FastBreak Foundation provides and supports hands-on programs that positively impact Minnesota youth. Through giving, education, and basketball opportunities, the Foundation enables young people to make responsible decisions, contribute to their future, and experience life-long memories.”

Each month during the 2013-14 season the FastBreak Foundation will focus on a specific area of giving. The month will feature events and a $5,000 grantto an organization that best fits the theme and fulfills the mission of the Foundation. Below is a list of the monthly themes.Please check the theme(s) you feel your organization's grant request matches:

___ October – New Season, New Beginnings

Organizations that offer youth a new direction or opportunity

___ November – Operation Minnesota Heroes

Organizations supporting Minnesota Military troops and their families

___ December – Season of Giving

Organizations that serve families in need during the holiday season

___ January – WolvesCare

Organizations that focus efforts on supporting children fighting life-threatening illness

___ February – WolvesFit

Organizations that focus efforts on health and fitness for youth

___ March – Read to Achieve

Organizations that focus on literacy and encourage a life-long love for reading

___ April – Wolves Think Green

Organizations that focus on preserving and improving the environment.

Organization Name: ______

Address: ______

City, State, Zip: ______

Contact: ______

Phone: ______Fax: ______E-Mail:______

Social Security/Tax ID #: ______

DIRECTIONS: Please answer each of the following items within the space provided.

BACKGROUND

Mission Statement: ______

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Program history: ______

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Description of purpose, goals, and objectives: ______

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Geographic area and target population served: ______

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PROPOSAL

Explanation of community need: ______

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How funding will be used: ______

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FINANCES

Description of annual fundraising efforts made on behalf of your organization:

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Past Timberwolves monetary donations/grants (include year and amount):

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REQUIRED MATERIALS TO SUPPORT APPLICATION

Please include copies of the following documents with your completed application form. Applications submitted without these materials will be considered incomplete and not reviewed for grant funding.

* A copy of the Internal Revenue Service ruling of tax-exempt status under Section

501 (c)(3)

* A COMPLETE BUDGET for the program, including itemized unearned income sources, both committed and pending

* A donor’s list of individual, corporate, and foundation contributions and the amounts granted during the past 12 months, along with an expense breakdown of the program you are requesting funds for and administrative expenses

* Financial statement from the most recent fiscal year (audited preferred)

* A list of the board of directors of the organization, including primary business or professional affiliation of each (addresses and phone numbers are not required)

* Annual report, if available

GRANT APPLICATION CHECKLIST

Before submitting your application, please carefully review this checklist to confirm that your grant proposal is complete:

1. Application Form

2. Supporting Materials

Grant proposals must be postmarked no later than September 13, 2013. The Timberwolves FastBreak Foundation Grant Committee will select the grant recipients and contact those organizations that will receive funding. Please contact with any questions.

Mail completed applications to:

Minnesota Timberwolves FastBreak Foundation

Attn: Grant Applications

600 First Avenue North

Minneapolis, MN 55403

Thank you for your interest in grant funding from the FastBreak Foundation.