Page 1 Kiwanis Club f Adrian Cmmunity Impact Grant Request Fr funding requests abve $5,000 The Kiwanis Club f Adrian intentinally takes actin t psitively impact ur cmmunity. We envisin a club united in service, building a vibrant cmmunity, while preserving ur heritage. Our gal is t revitalize Adrian, Michigan, by: by encuraging ecnmic develpment in Adrian by supprting educatinal develpment fr yung children by creating and supprting recreatin pprtunities fr the Adrian cmmunity Cmmunity Impact Grant Guidelines Prjects must align with at least ne f the three bjectives f the Kiwanis Club f Adrian stated abve. Cmmunity Impact Grants are reserved fr special, BIG IMPACT, ne-time prjects. Grant applicatins fr recurring events will nt be cnsidered. Funds shall be used slely fr the granted purpse. Agencies must be a 501(c)3 and prvide services within the Adrian area (Michigan). Funded activities shall cmmence in a timely manner and expenditures shall be made within 120 days f receipt f the grant. N grant will be given fr any purpse that wuld jepardize the tax-exempt status f Kiwanis Club f Adrian r the applicant rganizatin. Grant recipients shall acknwledge Kiwanis Club f Adrian in all prmtinal materials, activities, and prgrams funded by Kiwanis Club f Adrian funds. The Kiwanis Club f Adrian typically des nt entertain requests frm plitical r religius rganizatins, individuals, r fundatins (unless specifically identified fr ne specific purpse r event). At mst, Kiwanis will accept ne Cmmunity Impact Grant request per rganizatin per year. Applicatin Prcess Nn-prfit, cmmunity rganizatins wishing t apply fr financial supprt shuld fllw these steps. Please nte this is a multi-step prcess that takes apprximately 3 mnths t cmplete. Emergency financial assistance requests will nt be cnsidered. 1. Cntact the current Cmmunity Impact Cmmittee (CIC) Chair t cnfirm that funding is still available and the prject aligns with Kiwanis Club f Adrian gals. The current CIC Chair is Garry Clift (gclift@cliftaut.cm). 2. Submissin: Cmplete the attached grant applicatin and submit it electrnically via email in PDF frm t the current CIC Chair. Applicatins must be typed and all requested dcuments must be attached t the email. Identify a Kiwanian that is familiar with yur rganizatin s missin and may champin the prject thrugh the prcess. If yu are unable t identify a Kiwanian, ne may be chsen fr yu based n interest.
Page 2 3. Review Prcess: CIC REVIEW The CIC reviews requests n a mnthly basis the secnd Mnday f the mnth. Based n the submitted grant request, the CIC will take ne f three actins: Recmmend t the Kiwanis Club f Adrian Club Bard t mve frward with the request. (See the next bullet pint fr the remaining prcess.) Fllw-up with additinal questins t the requesting rganizatin befre actin is taken. Denial f the request based n funding availability r if the prject des nt align with the Kiwanis Club f Adrian gals/bjectives. If the grant request is denied, the rganizatin will be ntified by email r print letter. BOARD INITIAL REVIEW The CIC makes a recmmendatin t the Club Bard. The Club Bard meets mnthly n the first Thursday. The Club Bard will decide whether r nt t mve the prject alng in the prcess, r fllw-up with additinal questins. CLUB ADVISORY VOTE A presentatin t the general membership during a nrmal weekly club meeting will ccur. The presentatin will be made by the Kiwanis Club f Adrian champin, nt a member f the applicant rganizatin unless they are a member f Kiwanis. An advisry vte will take place via paper ballt, cllected, and cunted during the meeting. Results will be annunced at the end f the meeting. The vte must reveal a majrity in favr (51%) in rder fr the prject/request t mve frward. FOUNDATION REVIEW The Fundatin Bard will review the request t assure the funds are available. CLUB BOARD FINAL REVIEW The Club Bard will take a final vte n the prject and ntify the Fundatin, general club membership, and requesting rganizatin f the utcme. Payment may take 60-90 days. Prpsals must cntain the fllwing infrmatin and must be cmpleted accrding t the frm belw in rder t be cnsidered fr funding. Part 1: Cver Page Part 2: Narrative Part 3: Required Attachments Part 4: Certificatin
Page 3 Cmmunity Impact Grant Applicatin PART 1: COVER PAGE Organizatin name: Mailing address: Phne number: Prject crdinatr: Crdinatr email: Organizatin s missin: Prject name: Amunt requested: Gegraphic area served by this prject: What is the ttal prject cst and what percentage f the ttal budget wuld this grant accunt fr? Have yu secured r applied fr ther types f funding fr this prject? If s, please list surces, amunts, and status. Target ppulatin: Estimated number f persns t be served: Executive Summary: In 250 wrds r less describe yur prject. This summary shuld nt be cnfused with the entire applicatin which fllws.
Page 4 PART 2: NARRATIVE 1. Prvide a brief descriptin f yur rganizatin, its missin, and gals. 2. What is the gal f this prject what are yu trying t accmplish? Hw is the prject filling a need in the cmmunity? Dcument the need with statistics r testimnies. 3. Hw d yu feel the prject aligns with the missin f ur club The Kiwanis Club f Adrian intentinally takes actin t psitively impact ur cmmunity? Which f the club s three bjectives (stated at the tp f the first page) des this prject best fit? 4. The Kiwanis Club f Adrian is a service club. If yur rganizatin were t receive this grant, what vlunteer pprtunities wuld be available t ur club members that are cnnected t the prject? 5. Hw des yur prject stand ut r differentiate frm ther services f its types in the cmmunity? Is any ther lcal rganizatin ding similar wrk in ur cmmunity? 6. Describe resurces (human, financial, facility, equipment, etc.) available t yu fr cnducting this prject, and the additinal resurces needed. 7. Wh/what are the ther cnstituents invlved in the planning and implementatin f the prject? 8. Describe hw the prject will use vlunteer supprt, cperate with ther scial service agencies, and gather cmmunity supprt and invlvement. 9. Hw will yu measure this prject s success? 10. List in chrnlgical rder any financial supprt yu have received frm the Kiwanis Club f Adrian since 2015. Indicate the amunt f funding received and fr what prject/prgram it was utilized. 11. What will happen t the prject and/r the rganizatin if this grant request is nt fully funded by Kiwanis? At what funding level will it becme impssible t cmplete the prject? PART 3: REQUIRED ATTACHMENTS All 501(c)3 rganizatins, excluding gvernment and schl rganizatins, must include the fllwing: 1. Cpy f current prject budget 2. Cpy f Internal Revenue Service tax exemptin letter cnfirming 501(c)3 status 3. List f members f rganizatin's gverning bard, including addresses 4. Cpy f mst recent audit r Frm 990
Page 5 PART 4: CERTIFICATION T the best f my/ur knwledge and belief: statements in the attached applicatin are true and crrect; the dcument has been duly authrized by the gverning bdy f the applicant; and the applicant rganizatin will cmply with applicable laws, regulatins, terms, and cnditins in effect at the time f grant. I/we understand that the Kiwanis Club f Adrian, in evaluating this grant applicatin, may, if deemed apprpriate, review any and all f the infrmatin submitted as part f this request with advisrs f their chsing. I/we agree t cmply with the Equal Emplyment Opprtunity Act; prduce and dcument prject results; exhibit sund management; nt fcus n purely religius purpses; begin the prject/prgram within fur (4) mnths f receipt f funds; and expend the entire grant within ne year r return unspent funds. If a 501(c)(3) nn-prfit rganizatin: Signature f President r Executive Directr Printed Name & Title Date Signature f Prject/Prgram Crdinatr Printed Name Date Tax Id # If nt a 501(c)(3) nn-prfit rganizatin: Signature f Authrized Fiscal Agent Representative Printed Name & Title Date Fiscal Agent Organizatin Name Address Fiscal Agent Phne Number Email Tax Id # In signing this applicatin, the Authrized Fiscal Agent Representative verifies that the rganizatin will act as a fiscal agent fr any mnies awarded. [END OF APPLICATION]