Field of Interest FundsGrant Application

Please check our website for current due dates

A separate application must be filled out for each fund you are applying to.

River and General Environment Fund –This fund supports efforts that will make the riverfront more available to the public for recreation and educational activities and environmental projects. This fund has a rolling deadline.

Boggan/Holland African American Community Fund – This fund supports programs targeted at African American youth, but may also fund activities and programs benefiting the African American community at-large.

Tillman Cornelius Playground Fund – This fund supports the maintenance of playgrounds within Albion.

Application Deadline: Complete applications and materials are due no later than 4:00 p.m. on the due date. See for current due dates, as some funds only award on a bi-annual basis.Application deadlines are NOT postmark deadlines.

Please email the application to nd submit one hard copy with original signatures to our offices at 203 S. Superior Street, or via mail at PO Box 156, Albion, MI 49224.

Please note that each fund has a different grant amount range.

Eligibility

  • A 501 (c)(3) or other tax exempt organization must be the fiscal agent for the program
  • The program must benefit the greater Albion area

Restrictions

Limitations include: Grant funds cannot support the following:

•activities conducted outside the greater Albion area, unless serving individuals from the greater Albion area

•existing deficits, licensing fees, fines, penalties, interest or litigation

•fundraising or allocations to endowment or other restricted funds

•funds which the applicant would re-grant to other organizations

•cash prizes, contributions, donations

Albion Community Foundation •203 S. Superior St. • PO Box 156 • Albion, MI 49224 • 517/629-3349

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Albion Community Foundation
Field of Interest Funds

Grant Application Form – Cover

Applicant Organization's Name: / Project Director:
Mailing Address: / City: / Zip Code:
Organization Phone:
() - - / Organization Fax:
() - - / Contact Phone:
() - - / Contact Fax:
() - -
Organization Website (URL): / Contact Email Address:
Project Name: / Project Start Date:
/ Project End Date (please enter a specific date):
Est. Number of Direct Beneficiaries / Est. Number of Indirect Beneficiaries / Total # Benefiting:
Target Population Age Code:
Please ChooseallSchool Age k-12Senior 65+Children 0-18 infant 0-4adult 22-64young adult 19-21 Teen 13 -18Young Child 0-8Unknown / Target Population Gender Code:
Please ChooseBothFemaleMale / Target Population Economic Code:
Please ChooseAllBelow Federal PovertyHigh Net WorthLow IncomeUnknownMiddle Income
Grant Request Program Code:
Please Choose1 - Historical2 - LiteracyA - Arts and CultureB - EducationalC - Animal RelatedD - EnvironmentalE - HealthI - Public ProtectionJ - Employment and JobsK - Food and NutritionL - Housing, ShelterM - Public SafetyN - RecreationO - youth developmentP - Human ServiceRF- RiverfrontS - Community ImprovementT - PhilanthropyU - Science and TechW - Public/Society / Grant Request Secondary Program Code: Please Choose1 - Historical2 - LiteracyA - Arts and CultureB - EducationalC - Animal RelatedD - EnvironmentalE - HealthI - Public ProtectionJ - Employment and JobsK - Food and NutritionL - Housing, ShelterM - Public SafetyN - RecreationO - youth developmentP - Human ServiceRF- RiverfrontS - Community ImprovementT - PhilanthropyU - Science and TechW - Public/Society
Total Project Cost: / ACF Requested Amount: / Grant Request Type Code:
Please ChooseCapital CampaignBuilding/RenovationEquipmentComputer SystemsProgram DevelopmentPerformance/Production

Please select the field of interest fund you are applying to. (Please select ONE only). A separate complete application must be submitted for each fund.

Riverfront/Environmental Fund (grant range $100 - $2500) Tillman Cornelius Playground Fund(grant range $100 - $500)

Boggan/Holland African American Community Fund ($100 - $1000)

REQUIRED ATTACHMENTS – Please Provide One Copy of the Following (Via Email of Hard Copy)

Complete Project Budget Form (use attached Project Budget Form)

List of organization’s governing body andofficers

A copy of IRS tax exemption letter, if applicable

Page one of your most recent 990 (if you only file the 990-N please call)

A copy of the organization’s current operating budget. (For public entities, please include only the department, school budget that you are applying for.)

Signature of ApplicantTitle

Date

Authorizing Official SignatureTitle
(ie. Executive Director, Board Chair, City Manager, Superintendent)

I. NARRATIVE (All shaded areas reflect fill in fields and will adjust to the length of your response, you may tab between fields. Be sure to delete the examples. )

A.Summary

Insert the name of the group or organization applying for the grantlocated in City, State is requesting $enter amount of requestfrom the Albion Community Foundation to supportenter project name. The purpose ofthis projectis to address the need forwhat need will the program address, in one sentence.

This projectwill serve how many will receive direct servicesenter the type of audience receiving direct services, i.e. youth, adults, people, etc.from enter where is your audience from i.e. the greater Albion area, Albion Public School District, the city of Albion, etc..

The main goal(s) of the project is/areto list goal or goals.
In order to accomplish our goal(s)we will conduct the following activities (up to 10):

Activity 1: what is your first activity or set of activities, be sure to include quantities, ie 10 music classes will take place When will they happen ie. from 4 - 6 pm during the months of September and October. . This activity will directly serve how many and who will each activity serve, ie 10 second graders..

Activity:

Activity:

Activity:

Activity:

Activity:

Activity:

Activity:

Activity:

Activity:

B.Project Information

  1. Please state what you are asking the Advisory Committee to fund.

We are asking the Advisory Committee to fund please describe the specific portions of the project that you will use grant monies to support, if the request is for the entire project, you will still need to describe each major expense. Click here to enter text.

  1. How will this benefit the greater Albion area?

Through this program we will meet the following need describe the need or challenges that this project will be addressing.

By addressing this need, our target audience and the greater Albion area will benefit in the following ways:

Describe the benefits, such as increased access to something, higher test score, talk about things like the 40 developmental assets.

  1. How will you reach your target population and how do you plan to publicize/promote your project?(please check all that apply)

e-news organization newsletter flyers teachers website

press releases brochures counselors membership

announcements to different groups

existing program, not a new audience.

Other (please explain)

  1. How will you evaluate the proposed outcomes of your project?(please check only those that you will be implementing as samples of methods used will be required as part of your final report)

participant surveysparent surveys teacher surveys

focus groups observation attendancecounts

increase in test scores/grades

Other (please explain)

  1. How will the project be sustained after the grant period?(Please check the appropriate statement and complete if applicable.)

We plan on sustaining this project by: i.e. including the cost as part of our future annual operating budget, by increasing fees, etc.OR Due to the population being served we are unable to charge a fee for services,therefore, we will seek grants and sponsorships to continue the program

OR

This is a one-time project that will not require future funding.

  1. What will you do if you do not receive full funding?

If we do not receive full funding:

We will not be able to fund the program.

We will delay the start of the program until additional funds can be secured.

We will decrease the number of people served.

We will decrease the scope of the project.

Other (please explain)

  1. If the total project budget is greater than the amount requested, from what sources will the other necessary funds be obtained, and what funds have been raised to date?

As of the date of this application we have secured how much money - if none enter no additional funds for this program.

Additional funds will be secured:

No additional funds will be secured We will charge fees

Our organization has committed to the additional costs We will seek other grants

We will hold the following fundraiser(s) (please explain)

Other (please explain)

Itemized Project Budget Form: Please explain as much as possible what items are included in each expense category.

Revenue: / Pending / Committed
Grants/Contracts/Contributions
Local Government
State Government
Federal Government
Other Foundations
Corporations
Individuals
Earned Income
Events
Tickets, other
Membership Income
ACF Grant Request
In-Kind Support
Other (specify)
Sub-Total Cash and In-Kind Revenue
Total Revenue (Total Cash + Total In-Kind)
Expenses: / ACF Request / Applicant
Cost Share / Total Project Expenses
Salaries (itemize, i.e. Program Director (25 hrs x $20/hr)
Salaries (itemize, i.e. Program Director (25 hrs x $20/hr)
Salaries (itemize, i.e. Program Director (25 hrs x $20/hr)
Salaries ((itemize, i.e. Program Director (25 hrs x $20/hr)
Salaries ((itemize, i.e. Program Director (25 hrs x $20/hr)
Payroll Taxes what % x total salary cost
Fringe Benefits what % x total salary cost
Consultants and Professional Fees x $ per day, etc.
Insurance (itemize ie days x cost)
Travel
Equipment(quantity x unit cost)
Supplies (quantity x unit cost)
Printing and Copying(quantity x unit cost)
Telephone and Fax(quantity x unit cost)
Postage and Delivery(quantity x unit cost)
Rentx $ per day, etc.
Utilitiesx $ per day, etc.
Maintenancex $ per day, etc.
Evaluationx $ per day, etc.
Marketing/Advertising/Publicity (quantity x unit cost)
Other (specify)
In-Kind
Subtotal Total Cash and In-Kind Expense
Total Expenses
(Total Cost Share + Total In-Kind + ACF Grant Request)