Grant Application for Program/Project Initiatives

Applications may be submitted at any time and will be reviewed quarterly.

Please see web site for specific deadlines: http://www.dalnet.lib.mi.us/grants

Application for DALNET Program Initiative Reserve Funds, page 1/2 Version 01.3 5/08
1. Type of Submission:
Application
Changed/Corrected Application / 2. Type of Application:
New
Continuation
Revision
*Other (Specify)
3. Date of Application:
4. Applicant: / 5. Project Coordinator (Check if same as Applicant):
a. Name:
b. Institution*:
c. Title/Position: / a. Name:
b. Institution*:
c. Title/Position:
d. Mailing Address: / d. Mailing Address:
Street 1: / Street 1:
Street 2: / Street 2:
City: / City:
County: / County:
State: / State:
Province: / Province:
Country: / Country:
Zip / Postal Code / Zip / Postal Code
e. Telephone Number:
f. Fax Number: / e. Telephone Number:
f. Fax Number:
g. Email: / g. Email:
6. Title of proposed Program or Project:
7. Proposed dates for Program or Project:
a. Start Date/Date of Availability: AND b. End Date/End of Availability: OR c. Ongoing:
8. If this will be an ongoing program or project, how will it be sustained?
9. If a digital project is being proposed, will applicant’s institution require participation from the DALNET office for development, implementation, and/or delivery of the program of project? (If “Yes,” please complete a DALNET Digital Project Work Form and submit with application.)
Yes No

*This application is only for use by current DALNET members whose annual membership dues are paid in full for the current fiscal year in which the application is being submitted.

Application for DALNET Program Initiative Reserve Funds, page 2/2 Version 01.3 5/08
10. Will this Program or Project be accessible to the public? (If “No,” provide explanation.)
Yes No
11. Community or communities served by Program or Project (Groups, Institutions, Cities, Counties, States, etc.):
12. Complete and attach Appendix A (Evaluation Criteria). Answers provided to these questions will be used to evaluate the grant proposal.
13. Estimated Costs and Funding for this Program or Project**:
Request from DALNET / Applicant Institution / Other Funding Source / TOTAL Costs
a. Personnel
b. Equipment
c. Supplies
d. Other (Describe):
TOTAL Funding**
14. By signing this application, I certify that the statements herein are true, complete and accurate to the best of my knowledge. I also agree to comply with any resulting terms if I accept an award.
I AGREE Signature of Applicant***: Date:
15. Sponsoring DALNET Board Member (from Applicant’s institution):
Prefix: Name: Suffix:
Title:
Telephone Number: / Fax Number:
Email:
Signature of Sponsoring Board Member***: / Date:

**Grants awarded shall range from $250 to $20,000 per program/project. The applying institution must supply funding for a minimum of 25% of the total budget for the proposed program or project for awards of $15,000 or more.

***This application must be submitted electronically via email to . To officially complete the application, two (2) signed paper copies of the application must also be submitted to the DALNET office at the address noted below. Please contact the DALNET office for assistance in completing this form and/or with questions about the grant program or grant submissions.

In addition to your electronic submission, please submit two (2) signed paper copies of the application to:

DALNET

6th Floor SEL

5048 Gullen Mall

Detroit, MI 48202 6/16/2008; rev. 7/23/2008, 1/4/2011 Authorized for Local Reproduction