White Pigeon Area Community Foundation - Grant Application Form

INSTRUCTIONS - READ CAREFULLY:
Complete the following form in its entirety. After filling in the form, click the button to create your printable pages.

1. A cover letter should be included with each application, which introduces your organization and your grant proposal and makes a connection between your proposal and our mission and grantmaking interests. Please keep this cover letter to one typed page in length.
2. Please submit 8 copies of your grant proposal (including 8 copies of the grant cover sheet and grant budget).
3. Include a copy of the current IRS determination letter indicating 501 ( c ) 3 tax-exempt status.
4. Include a list of your Board of Directors and affiliations.
5. Include a copy of your organization’s current annual operating budget, including expenses and revenue.
6. Include a copy of your most recent annual financial statement (independently audited, if available; if not available, attach your Form 990. Only one copy of audit or 990 is required.
7. Include the attached Grant Budget Sheet (and 8 copies).
8. Include the attached Grant Application Cover Sheet (and 8 copies).
9. You may include letters of support for your project from other organizations.
10. Include your annual report, if available.
11. Grant money must be paid out within 1 year of approval.
12. Please call our office if you have any questions.

Application and required attachments must be returned to:
* Sturgis Area Community Foundation - 310 N. Franks Avenue - Sturgis, MI 49091

DUE DATE: Please call for grant application due dates. (269) 659-8508



The White Pigeon Area Community Foundation
GRANT APPLICATION COVER SHEET

Date of Application:
Legal name of school or organization applying:
(should be same as on IRS determination letter and as supplied on IRS form 990)
Year founded: Current Operating Budget:
Executive Director: Phone Number:
Contact person/title/phone number:
(if different than Executive Director)
Address (principal/administrative office):
City/State/Zip:
Fax Number:
Email Address:


List any previous support from
this funder in the last 5 years:

Project Name:
Purpose of Grant: (1 sentence)
Are there any other financial resources available for this project?
Date of Project: Amount Requested:
Total Project Cost:
Geographic Area Served:

BELOW IS A LISTING OF STANDARD BUDGET ITEMS. PLEASE PROVIDE THE PROJECT BUDGET IN THIS FORMAT

A. Organizational fiscal year:
B. Time period this budget covers:

EXPENSES
Amount requested from
The White Pigeon Fdn		 Total project expense
Salaries
Payroll taxes
Fringe Benefits
Consultants and
Professional fees
Insurance
Travel
Equipment
Supplies
Printing/copying
Telephone/fax
Postage & Delivery
Rent
Utitlities
Maintenance
Evaluation
Marketing
Other (specify)
TOTAL AMT REQUESTED:  
TOTAL EXPENSES:  
     
REVENUE
Committed Pending
Local Govt. Grants
State Govt. Grants
Fed. Govt. Grants
Foundation Grants
Corporate Donations
Individual Donations
Income from events
Income from products
Membership income
In-kind support
Other (specify)
TOTAL REVENUE: