1 Pikes Peak Kiwanis Benevolent Fund Grant Guidelines Revised August 2013 Level 1 New Organization Introduction to Pikes Peak Kiwanis Club Interface: Support: Current member becomes meets with key representative of the agency/group, and gathers info for club, and champions the cause 1. Application completed. 2. Define an initial project that benefits the agency, uses Kiwanis volunteers, etc. Up to $500 in financial support of a project or fundraiser. Kiwanis is recognized in any project-based support materials/sites. Level 2 Ongoing relationship and support from Pikes Peak Kiwanis Club Interface: Kiwanis is active in at least 1 project every 2-3 years; NOT only financially supportive. Agency rep attends at least one Kiwanis meeting per year. Kiwanis Champion maintains as key interface with agency. Application completed, results from previous year reported. Support: Cash donations up to $1000 (maximum, not an expectation) and/or 1-3 additional agency projects or fundraisers; additional funds possible to support the projects. Kiwanis is prominently displayed on any appropriate media as an ongoing supporter (website, pamphlets, presentations, etc.) Level 3 Relationship is complementary (Kiwanis to agency AND agency to Kiwanis) Interface: Support: Kiwanis is active in projects and regularly participates with the agency. Agency representative (employee, Board member, agency volunteer) becomes active member of Kiwanis and becomes Champion for their cause. Application completed, annual results reported. Cash donations up to $1,500 (maximum, not an expectation) and/or regular participation in projects that support the agency, projects, or fundraisers; additional funds possible to support the projects. Kiwanis is commonly introduced as a key stakeholder during presentations, on websites, etc. One Time Grants Kiwanis reserves the right to grant one time grants up to $250 at any time during the fiscal year (Oct-Sept) as it deems necessary. Applications will be filled out by the agency and have a Kiwanis representative assigned to the agency. One-time donation are not eligible in the next year, but may be designated as a Level 1 beneficiary.
2 SECTION ONE Date of Application Applicant Organization (Full Legal Name) Doing Business As Previous Name, if changed IRS letter date Tax Exempt ID # (EIN) If Applicable Name of Executive Director Name of Fiscal Sponsor (if applicable) Kiwanis Member Sponsor Name Proposal Contact Name Title Phone E-mail Street Address City State Zip Code Organization Website Mailing Address (if different than street address) City State Zip Code National/State Affiliate or Independent Organization? ORGANIZATION INFORMATION CONTACT INFORMATION
3 Organization s Budgeted Expenses for Current Year (give fiscal year end mm/dd/yy) Endowment Size (market value as of fiscal year mm/dd/yy) Organization s Major Funding Sources by percentage (e.g., United Way, local community foundation, county board of health, etc.) ORGANIZATION FINANCIAL INFORMATION $ $ Program/Project Title REQUEST DATA Total Budget for this Program/Project $ Amount of this request $ Anticipated Project Start Date Community/Counties served by this Program/Project Total Number of people to be served during grant period Brief demographic description of population served by this Program/Project Capital Operating Endowment Program/Project Start-up Signature of Applicant TYPE OF REQUEST (check all that apply) Other specify: SIGNATURES (both are required unless otherwise specified by funder) Signature of Kiwanis Member Sponsor
4 In general, the following narratives, which include Sections Two through Six, should not exceed 2 pages. SECTION TWO ORGANIZATIONAL BACKGROUND 1) Brief summary of organization s history and statement of organization s mission 2) Brief description of current programs/projects and activities 3) Evidence of organization s overall effectiveness based on achievement of specific organizational of program goals 4) Description of population and geographic region (community/county) served by this organization SECTION THREE PROGRAM/PROJECT DESCRIPTION & METHODOLOGY 1) Description of program/project, including: a) Summary description of overall program/project to be funded under this grant b) Brief description of goals and objectives for program/project & how it supports the Kiwanis mission to serve children of the world c) Timetable for implementation and duration of program/project 2) Brief description of how grant funds will be used? SECTION FOUR PROGRAM/PROJECT FUNDING PLANS 1) List of other funders to whom this current proposal has been and will be submitted. For each funder, indicate amount requested and status of request (e.g. to be submitted, pending, funded, or declined ). If funded, specify amount of grant and date received. 2) Other anticipated funding for this current proposal including: a) Earned revenue b) In-kind support
5 c) Special events d) Fundraisers, etc. 3) If this will be an ongoing program/project, describe plans and specific sources for future/long-term funding. SECTION FIVE REQUIRED NON-FINANCIAL ATTACHMENTS 1) Names and professional affiliations of board members and addresses OTHER Please return completed application to a member of The Kiwanis Club of Pikes Peak, or send by mail to: Pikes Peak Kiwanis Benevolent Fund, PO Box 1844, Colorado Springs, CO 80901 If you have questions about the application or our club, please visit our website for current contact information at www.pikespeakkiwanis.com