Minnesota Grant Application Form – Fill Out and Use This PDF

Minnesota Common Grant Application Form

Grant Application Cover Sheet

You may reproduce this form on your computer

Date of application:

Application submitted to:

Organization Information

Name of organization

Legal name, if different

Address

City, State, Zip

Employer Identification Number (EIN)

Phone

Fax

Web site

Name of top paid staff

Title

Phone

E-mail

Name of contact person regarding this application

Title

Phone

E-mail

Is your organization an IRS 501(c)(3) not-for-profit?

Yes

No

If no, is your organization a public agency/unit of government?

Yes

No

If no, check with funder for details on using fiscal agents, and list name and address of fiscal agent:

Fiscal agent’s EIN number

Proposal Information

Please give a 2-3 sentence summary of request:

Population served:

Geographic area served:

Funds are being requested for (check one) Note: Please be sure funder provides the type of support you are requesting.

General operating support

Start-up costs

Capital

Project/program support

Technical assistance

Other (list)

Project dates (if applicable):

Fiscal year end:

Budget

Dollar amount requested:

$

Total annual organization budget:

$

Total project budget (for support other than general operating):

$

Authorization

Name and title of top paid staff or board chair:

Signature

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Minnesota Common Grant Application Form

PROPOSAL NARRATIVE

Please use the following outline as a guide to your proposal narrative. Most grantmakers prefer up to five pages, excluding attachments, but be sure to ask each individual funder if they have page limitations or any additional requirements. Also, include a cover letter with your application that introduces your organization and proposal and makes the link between your proposal and the mission of the grantmaker to whom you are applying. For assistance with terms, refer to MCF’s Web site (www.mcf.org; select “Grantseeking in Minnesota”).

I.ORGANIZATION INFORMATION

A.Brief summary of organization history, including the date your organization was established.

B.Brief summary of organization mission and goals.

C.Brief description of organization’s current programs or activities, including any service statistics and strengths or accomplishments. Please highlight new or different activities, if any, for your organization.

D.Your organization’s relationship with other organizations working with similar missions. What is your organization’s role relative to these organizations?

E.Number of board members, full-time paid staff, part-time paid staff and volunteers.

F.Additional organization information required by each individual funder.

II. PURPOSE OF GRANT

General operating proposals: Complete Section A below and move to Part III - Evaluation.

All other proposal types: Complete Section B below and move to Part III - Evaluation.

A.General Operating Proposals

1.The opportunity, challenges, issues or need currently facing your organization.

2.Overall goal(s) of the organization for the funding period.

3.Objectives or ways in which you will meet the goal(s).

4.Activities and who will carry out these activities.

5.Time frame in which this will take place.

6.Long-term funding strategies.

7.Additional information regarding general operating proposals required by each individual funder.

B. All Other Proposal Types

1.Situation

a.The opportunity, challenges, issues or need and the community that your proposal addresses.

b.How that focus was determined and who was involved in that decision-making process.

2.Activities

a.Overall goal(s) regarding the situation described above.

b.Objectives or ways in which you will meet the goal(s).

c.Specific activities for which you seek funding.

d.Who will carry out those activities.

e.Time frame in which this will take place.

f.How the proposed activities will benefit the community in which they will occur, being as clear as you can about the impact you expect to have.

g.Long-term funding strategies (if applicable) for sustaining this effort.

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Minnesota Common Grant Application Form

III.EVALUATION

A.Please describe your criteria for success. What do you want to happen as a result of your activities? You may find it helpful to describe both immediate and long-term effects.

B.How will you measure these changes?

C.Who will be involved in evaluating this work (staff, board, constituents, community, consultants)?

D.What will you do with your evaluation results?

ATTACHMENTS

Generally the following attachments are required:

1.Finances (for assistance with terms, check MCF’s Web site at www.mcf.org.)

•Most recent financial statement from most recently completed year, audited if available, showing actual expenses. This information should include a balance sheet, a statement of activities (or statement of income and expenses) and functional expenses. Some funders require your most recent Form 990 tax return.

•Organization budget for current year, including income and expenses.

•Project Budget, including income and expenses (if not a general operating proposal).

•Additional funders. List names of corporations and foundations from which you are requesting funds, with dollar amounts, indicating which sources are committed or pending.

2.List of board members and their affiliations.

3.Brief description of key staff, including qualifications relevant to the specific request.

4.A copy of your current IRS determination letter (or your fiscal agent’s) indicating tax-exempt 501(c)(3) status.

5.If applying to a corporate funder only: if an employee of this corporation is involved with your organization, list names and involvement.

Be sure to check each funder’s guidelines, and use discretion when sending additional attachments.

PROPOSAL CHECKLIST

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Minnesota Common Grant Application Form

ORGANIZATION BUDGET

This format is optional and can serve as a guide to budgeting. If you already prepare an organization budget that contains this information, please feel free to submit it in its original form. Feel free to attach a budget narrative explaining your numbers if necessary.

	INCOME
	Source				Amount
	Support
	Government grants				$
	Foundations				$
	Corporations				$
	United Way or other federated campaigns				$
	Individual contributions				$
	Fundraising events and products				$
	Membership income				$
	In-kind support				$
	Investment income				$
	Revenue
	Government contracts				$
	Earned income				$
	Other (specify)				$
					$
					$
					$
	Total Income				$
	EXPENSES
Item					Amount
Salaries and wages					$
Insurance, benefits and other related taxes					$
Consultants and professional fees					$
Travel					$
Equipment					$
Supplies					$
Printing and copying					$
Telephone and fax					$
Postage and delivery					$
Rent and utilities					$
In-kind expenses					$
Depreciation					$
Other (specify)					$
					$
					$
Total Expense					$
Difference (Income less Expense)					$

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Minnesota Common Grant Application Form

PROJECT BUDGET

This format is optional and can serve as a guide to budgeting. If you already prepare project budgets that contain this information, please feel free to submit them in their original forms. Feel free to attach a budget narrative explaining your numbers if necessary.

	INCOME
Source			Amount
Support
Government grants			$
Foundations			$
Corporations			$
United Way or other federated campaigns			$
Individual contributions			$
Fundraising events and products			$
Membership income			$
In-kind support			$
Investment income	$
Revenue
Government contracts			$
Earned income			$
Other (specify)			$
			$

Total Income		$
EXPENSES
Item		Amount	%FT/PT
Salaries and wages (breakdown by individual
position and indicate full- or part-time.)		$
		$
		$
		$
		$
SUBTOTAL		$
Insurance, benefits and other related taxes		$
Consultants and professional fees		$
Travel		$
Equipment		$
Supplies		$
Printing and copying		$
Telephone and fax		$
Postage and delivery		$
Rent and utilities		$
In-kind expenses		$
Depreciation		$
Other (specify)		$
		$
Total Expense		$
Difference (Income less Expense)		$

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