R. Kubly Family Foundation, Inc. Grant Information

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LETTER OF INQUIRY This is the first step in the grant application process. Only organizations that submit a Letter of Inquiry and receive notification of acceptance from the Foundation will be eligible to submit a full grant application. Please create up to a two-page document containing the following information. Please do not include any attachments. Letters of Inquiry will receive notification within 90 days of submission; Applications will receive notification within 90 days of submission. 1. Organization Name 2. Grant Contact Name, Title & Email 3. Organization Executive Director or Board President Name & Email 4. Organization Address & Phone 5. Organization tax ID number / EIN 6. Organization Mission 7. Project Name and Expected Start & End Date 8. Project Budget: Include (1) the project total, (2) funds raised/pledged to date, and (3) funds requested from the R. Kubly Family Foundation. A very brief budget narrative is optional. 9. Project Description: Summarize the project. Describe the purpose of the proposed project, the issues that will be addressed, the significance of those issues, and the impact on Monroe, Wisconsin. Also include the audience that will benefit and the size of the audience. Describe how your project will expand or complement existing community services, plus any arrangements to collaborate with other organizations. Describe the sustainability of the project. 10. Proposed Outcome: List up to three measurable outcomes for the project. 11. R. Kubly Family Foundation Alignment: Describe how the project furthers the mission of the R. Kubly Family Foundation listed in the Grant Guidelines. Page 1 of 7

APPLICATION INFORMATION & INSTRUCTIONS Only organizations that submit a Letter of Inquiry and receive notification of acceptance from the Foundation will be eligible to submit a full grant application. Applications received between by August 31 will receive a response by November 15. Please note: A Letter of Inquiry must be accepted and approved prior to an Application being submitted. Include one copy of each of the following attachments: o 501(c)(3) Certificate of Tax Exemption o List of board of directors and their affiliations o If an applicant organization is not a federally registered 501(c)(3), another organization must agree to serve as fiscal agent. A letter of agreement signed by both parties and a copy of the fiscal agent s 501(c)(3) must accompany the proposal. Grant recipients may be asked to make a brief presentation about the project to the R. Kubly Family Foundation. Mailed applications should be sent to: 1112 7 th Avenue Monroe, WI 53566 Emailed applications should be sent to: info@kublyfamilyfoundation.org A final evaluation assessing project outcomes must be completed by the grant recipient within three months of the completion of the project and provide to The R. Kubly Family Foundation. Grant recipients who fail to complete this assessment will not be eligible for future grants. Questions about the grant process may be directed to Kim Markham, The R. Kubly Family Foundation at info@kublyfamilyfoundation.org Page 2 of 7

APPLICATION COVER PAGE Annual Application Deadline: August 31st Application Date: Name of Applicant Organization: Address: Executive Director: Phone: Email: Grant Contact Person and Title: Phone: Email: Project Name: Project Start & End Dates: Total Project Budget: $ Amount Requested: $ Date Funding Needed: Major sources of funding for the organization by percent and amount: Your organization s federal tax exempt number: Has the governing board of your organization adopted a policy which states that the organization does not discriminate on the basis of age, race, religion, gender, marital status, sexual preference, disability or national origin? Yes No Date policy adopted: Page 3 of 7

DESCRIPTION OF REQUEST Please read all application questions before answering, to provide for a more efficient, nonduplicative application. Whenever possible, please use bullets to provide concise, easy to follow, informative answers. 1. Description of Applicant Organization Describe the mission, purpose and programs of your organization. 2. Project Purpose Statement Outline the purpose of your project. Explain specifically how the requested funding furthers the mission of the R. Kubly Family Foundation listed in the Grant Guidelines. What will your main impact be on Monroe? Who is the main audience for this project? Page 4 of 7

3. Activities/Strategies Describe the activities and/or strategies to accomplish your proposed purpose. 4. Qualifications What are your organization s qualifications and system for running this project? 5. Proposed Outcomes/Indicators How do you hope to measure your results, to know if your project has been successful or not? What will the indicators be to show the success of your project? Outcome measurement is a cornerstone of the R. Kubly Family Foundation s grant making. For information on this approach to project design and evaluation, please consult published resources listed on the last page of this report. A final grant evaluation, including a detailed expense report will be required. Page 5 of 7

6. Project duration - what is the timeline for your project to be developed, to be implemented, to be operated, and to be completed? 7. Budget on a separate page, preferably in spreadsheet format, please provide a lineitem budget covering all projected expenses for this project. Signature of Grant Application Contact Person Date Signature of authorized Board Member Date Signature of Executive Director Date Page 6 of 7

OUTCOME MEASUREMENT RESOURCES The Basic Guide to Outcomes-Based Evaluation for Nonprofit Organizations with Very Limited Resources, developed by Carter McNamara, a management consultant in St. Paul, Minnesota, is a good resource. This online guide is available to view at: https://managementhelp.org/evaluation/outcomes-evaluation-guide.htm Page 7 of 7