Beulah Drake Grant Program

Beulah Drake Grant Program

Application for Funding

Oregon Wildlife grants fundsup to $5,000 for fish and wildlife related projects. Please contact our Executive Directorif you would like to apply for anamount larger than $5,000. Foundation funds must be matched equallywith cash, in-kind support, or a combination thereof from other sources. Funding consideration is given to nonprofit organizations, government agencies and qualified individuals for fish and wildlife related projectsin Oregon. To complete this application, you will need familiarity with ODFW’s Conservation Strategy. Use the Conservation Opportunity Area (COA) Explorer to identify the name and location of the COA you will work in.Click hereto visit the COA Explorer at the ODFW website to locate your project site. Please note that the COA “profile” displays as a pop up; you will not be able to view it if your browser is set to block pop ups. If your proposed project is not located in a COA, the name and location of the nearest COA should be shown on your application.
The Foundation’s Project Committee meets quarterly to review and approve proposals for funding. If a grant award is made to you, post-project reporting requirements include; a project report,press releasecrediting Oregon Wildlife, copies of any resulting media stories, andbefore/after pictures of the project. Application due dates for 2013 are February 13th, May 6th, August 12th, and November 19th.

1. / Today’s Date:
2. / Project Title
3. / Applicant
Address
City / State / Zip Code
Contact Person: / Phone: / ()-
Email:
Signature
4. / Type of Project / Fish / Wildlife / Other
5. / Proposed Start Date / Completion Date
6. / Estimated Project Cost / $ / Funding Requested / $
7. / Project Location (attach map showing location) / County:
Nearest Town or City:
Is this project within a COA? Yes No
If “Yes”, what is the name of the Area?
If “No”, what is the name of the nearest Opportunity Area?
8. / Has an ODFW or USFWS biologist reviewed this project Yes No
If “Yes”, print name: / Phone Number: / () -
Email
Attach a support statement from an ODFW or USFWS biologist to this application
9. / Explain, in an attachment to this application, your proposed project. Please include:

You and your organization’s background and that of this proposed project
What you will accomplish
The need for this project
Relationship, if any, to the priorities in the Oregon Conservation Strategy, and
The benefits that will accrue from completing this project.

10. / Complete the budget below or include as an attachment if you need or want to provide more detail.
Budget
Category / OWHF
Request / Other
Sources / Detail
Personnel / $ / $
Contractual Services / $ / $
Office Expenses / $ / $
Project Supplies / $ / $
Equipment / $ / $
Travel / $ / $
Miscellaneous / $ / $
Total / $ / $
11. / Who are the other participating organizations and what will they contribute to the project?
Agency/Organization / Cash / In-Kind / Other (List)
$ / $
$ / $
$ / $
$ / $
12. / What conditions, if any, have been placed on the support shown above that may impact completion of this project? Explain below. Attach an additional sheet if necessary.
13. / Who will monitor, maintain and/or operate the project once completed?
14. / Forward at least two photos of the project/location to
15. / I understand that I am required to submit the following information to the Foundation at the completion of the project: Project Completion Report a press release crediting Oregon Wildlife Copies of any resulting media coverage Pictures (at completion)
16. / Name: / Signature: / Title:

Send your application and required attachments (one signed hard copy, one electronic) to:

Oregon Wildlife
P.O. Box 30406
Portland, Oregon 97294-3406
Fax Number: 503.255.6467
/ For more information:
Telephone: 503.255.6059

For Staff Use Only:
Application Complete Project Description Attached Biologist’s Statement Attached
Additional Attachments:
Staff Comments:

Beulah Drake Grant Program – Project ApplicationPage 1