2018 SSNHA General Grant Application

Transcription

1 2018 SSNHA General Grant Application Applicant Information 1. Applicant Name (Name of non-profit organization, local government, etc.) 2. Applicant Type: Non-Profit Organization Governmental (City, County, State, Regional) Federally Recognized Indian Tribe

2 3. What is your current Partner Site Status? Designated Emerging Neither, but we plan to become designated Neither, with no plans to become designated 4. If you do not have plans to become a designated site, please explain why. 5. Applicant's Federal ID Number 6. Attach IRS Letter of Determination of Non-profit Status. After you have chosen the file, click upload. Browse...

3 7. Applicant Contact Name: First Name Last Name Title Organization Name Street Address Apt/Suite/Office or N/A City Zip County Address Phone Number Format must be (XXX-XXX-XXXX)

4 Project Information 8. Project Name 9. Project Description (Please describe in one sentence, 25 words or less) 10. Street Address of Project Location 11. City of Project Location

5 12. County Name of Project Location (Select all that apply) Allamakee Benton Black Hawk Boone Bremer Buchanan Butler Cedar Cerro Gordo Chickasaw Clayton Clinton Delaware Dubuque Fayette Floyd Franklin Grundy Hamilton Hardin Howard Iowa Jackson Jasper Johnson Jones Linn Marshall Mitchell Polk Poweshiek Scott Story Tama Winneshiek Worth Wright

6 13. What is the budget for the proposed project? (These totals should match those listed in your itemized budget.) Lines will not add up, so please ensure your calculations are correct. Grant applicants must provide 1-1 match to the grant request. At least half of the applicant's contribution must be in cash. Amount Grant Amount Requested Amount of Cash Match Value of In-Kind Support Total Project Budget 14. Project funds will be used for the following type of activity: (Check all that apply) Exhibits Outdoor Interpretive Signage Marketing Educational Programs Interpretive Programs Event Other

7 15. Will this project include elements related to the current agricultural story? Yes No Project Summary 16. Specifically describe the grant project in a clear and concise summary. Begin by completing this sentence: The (name of your organization) seeks a SSNHA General Grant to. (Maximum of 1800 characters) In an effort to expand the current agricultural story in the Heritage Area, greater consideration will be given to projects and programming that incorporate interpretation of the current agricultural story.

8 17. Goals Address the goals of this project and how it fits into the overall goals for your site or organization. Explain how the project fulfills a demonstrated area of need. (Maximum of 1800 characters) Interpretive Themes

9 18. Number in order of priority those interpretive themes which relate to this grant project as applicable. Drag items from the left-hand list into the right-hand list to order them. The Fertile Land Farmers & Families The Changing Farm Higher Yields: The Science & Technology of Agriculture Farm to Factory: Agribusiness in Iowa Organizing for Agriculture: Policies & Politics

10 19. Describe and/or attach examples of how your theme(s) will be preserved or interpreted. Include references to subcategories from the SSNHA Interpretive Plan. (Maximum of 1800 characters) 20. When applicable and where available, attach an interpretive plan, exhibit design, sign design, or other documents to illustrate your project. After you have chosen the file, click upload. Browse...

11 21. How does the project contribute to telling the story of agriculture; does it enhance or expand new or different stories? How will the SSNHA be recognized in the grant project? Describe how the Heritage Area will have a role in this project (SSNHA Staff & Partner Sites). (Maximum of 1800 characters)

12 22. Visitor Experience Need How will the proposed project develop positive visitor experiences consistent with the SSNHA Interpretative Plan? (Maximum of 1400 characters) Timeline/Evaluation

13 23. Describe the timeline of the project. List key threshold tasks including approximate beginning and ending dates for each task. From date To date Describe timeline of task Add Another Task

14 24. Evaluation How will you evaluate the project goals after completion? (Maximum of 900 characters)

15 25. What are the anticipated outcomes to individuals, customers, participants as a result of this project? (Maximum of 900 characters)

16 26. What are the anticipated impacts to your organization or community because of this project? (Maximum of 900 characters) Project Budget

17 27. Project Budget Please complete the following budget for your project and attach a Budget Explanation below to further explain budget items in detail. **See Page 3 of Grant Information Packet for match clarification. In-kind matches must be directly attributable to the project. Personnel time for employees, volunteers, and consultants as well as contributions of services, materials and supplies are considered in-kind match.** Grant Request Cash Match In-Kind Subtotal Consultant Personnel Use Contract for Services Travel Expenses Equipment Expenses Materials & Supplies Other Expenses Column Totals 28. Attach a Budget Explanation to further explain budget items in detail. After you have chosen the file, click upload. Browse...

18 29. Source of Cash and/or In-kind Match. (Maximum of 600 characters) 30. Attach letter documenting applicant's match of funding. After you have chosen the file, click upload. Browse... Support for Project

19 31. Support for Project List supporters of the grant project. If you list a supporter, please provide documentation of their support. For example, letter of support, supporting evidence of feasibility, press coverage of project. Supporter Description of Support Upload corresponding documentation of support for project. (Attach up to five documents) Browse...

20 33. Sustainability What is your plan to sustain the project beyond this grant? (Maximum of 900 characters). 34. Upload anything else you would like to attach to the General Grant Application. After you have chosen the file, click upload. Browse... Signature & Confirmation

21 35. By signing below, I verify that a) I have read all of the guidelines and agree to abide by them for the 2018 Silos & Smokestacks National Heritage Area General Grant. b) By entering my name below I am also verifying that all the information above is correct and true. Clear Sign name using mouse or touch pad Signature of