Robert E. and Genevieve B. Schaefer Fund for Chillicothe
of Community Foundations, Inc.
The purpose of the Robert E. and Genevieve B. Schaefer Fund for Chillicothe is to benefit the residents of Chillicothe and/or Ross County. The Robert E. and Genevieve B. Schaefer Fund supports programs that enhance the community in three broad areas: culture development, health and human welfare, and economic development. The fund welcomes applications from organizations recognized under Section 501 (c)(3) of the Internal Revenue Code.
The fund makes no grants to individuals, churches, governmental agencies or school districts. Organizations are discouraged from seeking general operating support or multi-year funding except for special circumstances. Please note that organizations may receive funding two years in a row, but are discouraged from applying in the third, subsequent year.
Applications must be submitted by email by the last Friday in October. Late applications are not accepted. Decisions will be announced 3 to 4 months after the application date. In addition to responding to the project narrative listed below, please include the following:
Proposal Elements
· Proposal coversheet
· Project budget form; and organization operating budget form for current fiscal year including income sources and expenditures. Also, where appropriate, identify other current or potential sources of support for this project
· Project Narrative (see below)
· All organizations with budgets over $75,000: an audit. Those with budgets less than $75,000: form 990 and compiled financial statements (electronic or pdf copies).
· List of the members of the Governing Board or policymaking body
· Letter of authorization from the board for submitting the grant request
· Copy of Internal Revenue Service 501(c)(3) letter
· No more that two letters of collaboration, partnership, or support
Project Narrative
To complete this application, please compile the following information. Limit your narrative to four or fewer pages and no less than 12-point type. Handwritten applications will not be accepted.
· Provide a brief history of the organization (mission statement, description of the programs you offer, population served, how your organization is funded, names and qualifications of key staff members).
· Describe the project for which you are seeking funding and how this project will benefit or contribute to the cultural and/or economic life of the residents of Chillicothe and/or Ross County?
· Include your project goals and objectives and projected outcomes or changes to be achieved.
· Provide your plan for evaluating the project. (Grantees will be asked to submit a final report one month after funding ends.)
· Explain your plan for raising money to continue the project once the grant ends.
Applications are to be electronically submitted as one, combined PDF attachment to . Questions may be directed to Robert B. Althoff (740/773-0902), Jerry B. Whited (740/702-2600), E. Joel Gerber (), or to Hailey Stroup at The Columbus Foundation at 614/251-4000 or .
Robert E. and Genevieve B. Schaefer Fund for Chillicothe
General InformationOrganization Name:
Address: / Executive Director:
Executive Director E-mail:
Project Director:
Project Address (if different from above) / Project Director Phone Number:
Project Director E-mail:
Project Information
Amount Requested: / Time Period of Project:
From: / To:
Brief Description of Project (limited to space provided):
I certify that the above information is true to the best of my knowledge.
Signature of Executive Director / Print Name
Title / Date
The organization above has the authority to submit this request.
Signature of Board Chair / Print Name
Title / Date
Project Budget
Organization Name:
PROJECT REVENUE
/Anticipated
/Committed
/Total
Contributed Income
/ / /Local Government
/ / /0
State Government
/ / /0
Federal Government
/ / /0
The Columbus Foundation
/ / /0
Other Foundations*
/ / /0
Corporations*
/ / /0
Board/Individual Contributions
/ / /0
Other*
/ / /0
Earned Income
/ / /Client Fees
/ / /0
Membership Dues
/ / /0
Contract Services*
/ / /0
Publications and Products
/ / /0
Ticket Sales
/ / /0
Organization Income
/ / /0
Other*
/ / /0
Total Project Revenue
/$0.00
/$0.00
/$0.00
PROJECT EXPENSES
/Foundation Request
/Other
Funding
/Total
Personnel Expenses
/ / /Salaries and Wages*
/ / /0
Fringe Benefits
/ / /0
Non-Personnel Expenses
/ / /Contract Services/Professional Fees*
/ / /0
Office Space
/ / /0
Equipment/Supplies
/ / /0
Staff/Board Development
/ / /0
Travel/Related Expenses
/ / /0
Indirect Costs*
/ / /0
Other*
/ / /0
Total Project Expenses
/$0.00
/$0.00
/$0.00
Excess* (Deficiency)*
/ / /$0.00
* Please list or explain in narrative
Total Organization Budget For Current Fiscal YearOrganization Name:
Fiscal year start and end date (m/d/yy): to
REVENUE/SUPPORT
/Budget for Year
/ Year–to-Date Budget(Specify date )
Corporate grants
Foundation grants
Govt. grants/contracts/per diem (identify*)
Individual Contributions
United Way
Other federated campaigns (identify*)
Board Contributions
Membership dues
Special events, fundraisers
Sponsorships
Admissions
Sales, rent
Revenue, tuition
Investment income
Interest, dividends
Other
Total Revenue/Support
/ $0.00 / $0.00EXPENSES
Salaries
Employee benefits, taxes
Professional fees
Equipment, supplies, materials
Telephone, utilities
Postage, mailing
Occupancy
Insurance
Training, staff development
Travel
Conferences
Evaluations
Other
Total Expenses
/ $0.00 / $0.00Revenue less Expenses / $0.00 / $0.00
*Identify = Please explain in narrative
If expenses exceed revenues/support, please explain how difference will be offset
Community Foundations, Inc. · 1234 East Broad Street · Columbus, Ohio · tel 614/251-4000 · fax 614/251-4009
columbusfoundation.org