Each grant application requires a copy of the following information: If the required information is not submitted, the application will be considered incomplete and will not be reviewed. Please note that a separate request is needed for each project. *All application questions must be answered in full within this grant application format.*

• Cover Letter
• Chisholm Community Foundation Completed Grant Application
• IRS Letter Designating 501C3 Status
• List of Current Board of Directors
• Copy of most recent audit, review or compilation
• Overall Organizational Budget
• Specific Project Budget
• Signature of Authority

All organizations requesting grants may be asked to be interviewed by representatives of the CCF Grant Committee. Site Inspections may also be conducted.

Phone

This field is for validation purposes and should be left unchanged.

Name of Organization (Legal Name)(Required)

Address(Required)

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Contact Person(Required)

Title(Required)

Phone(Required)

Email(Required)

Tax Status(Required)

501c3 (Include Status Forms)

Public Agency (Gov't Created)

Purpose of Organization(Required)

Type of Project (check all that apply)

Arts/Culture

Community Revitalization

Economic Development

Education

Environmental

Historic Preservation

Social Service

Public Heath & Safety

Other

Other (Explain in Detail)(Required)

Project Start Date(Required)

MM slash DD slash YYYY

Project End Date(Required)

MM slash DD slash YYYY

Total Project Budget(Required)

Amount Requested from CCF Grant(Required)

Project Description:

Name of Project(Required)

Geographic area to be served by project(Required)

Chisholm

Balkan

Both

Number of people impacted by project(Required)

Please provide an overview of your project, including the goals and anticipated outcomes.(Required)

Please explain in detail how the grant dollars from the CCF will be used towards your project (please remember that the CCF does not grant for any Operating Expenses).(Required)

How will this project specifically benefit the citizens of Chisholm and/or Balkan?(Required)

Please outline the specific activities and steps required to complete your project.(Required)

Please provide the names and qualifications of individuals involved in the project.(Required)

Project Budget:

Please specify any other grants, financial assistance, and other sources of funding for this specific project.(Required)

What strategies will you employ to ensure continued funding for this specific project after the grant funds are expended?(Required)

What methods will you use to publicly recognize the Chisholm Community Foundation's support for your project?(Required)

**Please note that projects with matching funds will be prioritized for grant consideration. **

Please indicate the specifics below for any matching funds that have been obtained below.

Matching funds for another grant(s):

Matching Funds for another grant(s):

Dollar Amount

Matching Funds Information

Matching funds from other sources:

Matching funds from other sources:

Dollar Amount

Matching Funds Information

***Exclusion of required information will result in denial of your request! ***

A final project report must be submitted to the Chisholm Community Foundation within one year of receiving the grant. Failure to submit the report will result in ineligibility for future grant opportunities.

Cover Letter Upload(Required)

Drop files here or Select files

Max. file size: 50 MB.

IRS Letter Designating 501c3 Status(Required)

Drop files here or Select files

Max. file size: 50 MB.

List of Current Board Memebers(Required)

Drop files here or Select files

Max. file size: 50 MB.

Copy of Most Recent Audit, Review or Compilation(Required)

Drop files here or Select files

Max. file size: 50 MB.

Overall Organization Budget(Required)

Drop files here or Select files

Max. file size: 50 MB.

Specific Project Budget(Required)

Drop files here or Select files

Max. file size: 50 MB.

I have downloaded and reviewed the Grant Bylaws Document.

I have downloaded and reviewed the Grant Bylaws Document (click to download).

Name of Authority (i.e., superintendent, city clerk, board chair)(Required)

Signature of Authority(Required)