The Foundation for the Enhancement of Mitchell County
509 State Street, Osage, IA 50461
641.732.4790
Grant Application Overview
Mission Statement: The mission of the Foundation for the Enhancement of Mitchell County is to foster private giving, strengthen service providers and improve the conditions of Mitchell County. To these ends, the foundation will promote endowment building, grant making, organizational collaboration, and public leadership for the benefit of the Mitchell County area.
What we support: The FEMC looks for projects that address significant community issues; present innovative, creative, and practical proposals which build on community strengths; develop the leadership potential of the community; involve the people served in the planning and implementation of the program; provide a plan for sustainability beyond the funding period; and capital projects that impact a significant number of county residents.
Eligibility to Apply for Funding:
Tax exempt, non-profit entities classified by the IRS as 501(c)(3) or a 170 (c)(1) governmental entity
If not 501(c) (3), must have a fiscal sponsor who will be legally & financially responsible
One application per organization
Grant request maximum is $10,000 with all grant requests over $1,000 leveraging AT LEAST 25% of request.
Application Deadline:
Due by 4:00 p.m. on Monday, September 14th, 2015
Affiliate Grant Application Contact Information:
FEMC
509 State Street
Osage, IA 50461
641.732.4790
Deliver completed application to:
FEMC
509 State Street
Osage, IA 50461
Grant Application Instructions
Checklist/Instructions:
Signed Grant Application Form
Letter of Application
Project budget/timeline/list of the organization’s Board of Directors (In attached format)
Signed Fiscal Sponsorship Agreement (Reminder - only 501 (c) (3) and 170b organizations eligible applicants) (one copy only if applicable)
Attach 501(c) (3) and/or 170b documentation (1st page only) – FROM ALL APPLICANTS (one copy only)
Submit 13 hard copies of the final packet – each packet should include NO MORE than 4 pages!
Definitions/Explanations
Fiscal Sponsor: is an organization that is receiving the money on behalf of the grant applicant and is responsible for disbursing the money for the project and maintaining appropriate documentation. This entity must be a 501(C)(3) or a 170 (c)(1) unit of government in order to serve in this capacity. A fiscal sponsorship agreement must accompany the grant application if a fiscal sponsor is being used.
Organizations must be recognized by the Internal Revenue Service as tax-exempt, nonprofit, public charities under section 501(c)(3) or as a “unit of government” under Section 170(c)(1) to receive grant funding. A 501(c)(3) is a section of the Federal Tax Code, which establishes the criteria for tax-exempt charitable organizations. Section 170(c)(1) refers to agencies that conduct activities to benefit the public at large, like public schools, state universities, public libraries and volunteer fire departments.
Grant Application Cover Page
Organization(s) conducting project:
Address:
Organization/Project Contact Person & Title:
Organization/Project Contact Person Phone & Email:
Project Title:
Fiscal Sponsor – required if the applicant organization is not a 501(c)(3) or 403 (b):
Federal tax identification number of Applicant(s) or Fiscal Sponsor (EIN):
Fiscal Sponsor Address:
Fiscal Sponsor Contact Person & Title:
Fiscal Sponsor Contact Person Phone & Email:
Total Cost of Project: Amount Requested:
Type of Request (check one): Capital Based Program Based
Program Based: Operational, activity, general programmatic support OR Capital Based: The building of or physical improvement of something
Project Focus Area (check one):
Life Learning Environmental Quality Community Development Health & Fitness
Brief Description of Organization:Brief Description of Project:
______
Signature of Authorized Project Representative/TITLE Date
Letter of Application
Please address the following discussion points in the Foundation for the Enhancement of Mitchell County application, limiting the letter to two pages (12 font, one inch margins). Please answer questions in this order.
1. Describe the project; make sure you describe you how project is an ENHANCEMENT to what your organization already does.
2. Describe the specific purpose for the grant funding and select the ONE Community Need/Problem/Benefit to Community being addressed by this project? (FEMC goal areas: Life Learning, Environmental Quality, Community Development, Health & Fitness)
3. Indicate desired outcomes and measurable results.
4. Describe how the project will be PUBLICLY communicated and how the FEMC recognized.
5. Is this a one-time project? If not, describe the long-term plan for sustainability of the project.
Budget/Timeline/Board of Directors
Detail other funding sources secured, applied for, and proposed for the project (highlight status of funding under amount in each source). Specify the amount you are requesting from the FEMC and timeline for project.
PROJECT BUDGET
Budget Item Source A: Source B: Source C: Source D: Source E: Source F:
(Categorize project parts) Lead Applicant Applicant - 2 FEMC
Total Source A: Total Source B: Total Source C: Total Source D: Total Source E: Total Source F:
TOTAL PROJECT (all funding / Source A-F total): ______FEMC REQUEST (Source C): ______
(Not to exceed 75% of total project amount for projects exceeding $1,000)
PROJECT TIMELINE
Project Start DateIdentify Key Milestone Dates
Project Completion Date
ORGANIZATION BOARD OF DIRECTORS
President/ChairmanVice President/Vice Chairperson
Secretary
Treasurer
Other Board Members
Fiscal Sponsorship Agreement (only 1 copy needed upon submission if applicable)
Date:
Fiscal Sponsor (Legal Applicant):
Fiscal Sponsor Contact Person and Email:
Fiscal Sponsor Full Mailing Address:
Sponsored Organization Conducting Project:
Project Name:
______(Legal Applicant/Fiscal Sponsor, hereafter referred to as The Sponsor) has agreed to serve as a fiscal/program sponsor for the ______(Organization conducting project, hereafter referred to as the Sponsored Org.) as outlined in the attached application and supporting materials. The Board of Directors of The Sponsor has passed a resolution adopting the Sponsored Org.’s project as a program or project consistent with the Sponsor’s purpose and mission. The Sponsored Org.’s financial activities will be accounted for as a program of The Sponsor for IRS auditing and financial reporting purposes.
Since the Sponsored Org. is not recognized by the IRS as a charitable tax-exempt entity, The Sponsor must exercise full control over the Sponsored Org.’s financial administration, management and disbursement of funds resulting from this grant application. The Sponsor has delegated ______(name of person/s) as responsible for fulfilling of these accounting and reporting functions subject to the ultimate authority of the Board of Directors of The Sponsor. The Sponsor is responsible for ensuring completion of timely reports and submission of necessary financial statements to the Community Foundation’s Administrative Office (contact info below). Failure to insure timely reporting on behalf of the Sponsored Org./Sponsor will also result in a loss of good standing.
This agreement will be in effect from the date of a grant award to support the above-named project until the grant funds are expended and the final report has been submitted and accepted.
We agree to the terms stated above in this agreement:
Legal Applicant/ Fiscal Sponsor Representative Signature:
Printed Name: Date:
Sponsored Organization Representative Signature:
Printed Name: Date:
*Attach to this agreement the Fiscal Sponsor’s 501(c)(3) Tax-Exempt Determination Letter or comparable proof of charitable exemption. (i.e. a letter from a City, confirming their status as a government entity. Contact our Administrative Office with questions, or for examples of a letter from a City.)*
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