New Jersey Council for the
Humanities
28 West State Street, Sixth Floor
Trenton, NJ 08608
Phone: (609) 695-4838
Email: grants@njch.org
Web: http://njch.org
2015 Community Discussion
Grants Program Application
OFFICE USE ONLY
Date Rec’d: __________________
Proposal #: __________________
Date Rev’d: __________________
Grant #: ____________________
Amount Funded: ______________
Program Officer’s Initials: _______
Format: _____________________
Final Report Due: _____________
PROJECT SUMMARY:
Project Title: Click here to enter text.
Overview (100 words or less): Click here to enter text.
Total Amount of Grant Request: Click here to enter text.
Proposed Grant Period: Click here to enter a date. – Click here to enter a date.
APPLICANT ORGANIZATION:
Name: Click here to enter text.
EIN: Click here to enter text.
DUNS: Click here to enter text.
Mailing Address: Click here to enter text.
Website: Click here to enter text.
PROJECT OFFICIALS:
• Project Director (The person directly supervising the completion of this project.)
Name: Click here to enter text.
Phone: Click here to enter text.
Title: Click here to enter text.
E-mail: Click here to enter text.
• Authorizing Official (The person authorized to submit a grant application on behalf of the applicant organization. He or
she must be an employee or board member of the applicant organization.)
Name: Click here to enter text.
Phone: Click here to enter text.
Title: Click here to enter text.
E-mail: Click here to enter text.
• Fiscal Officer (The primary administer of this project's budget. This person must be different from the project director
and either an employee or board member of the applicant organization. If the project is awarded, all payments will be
mailed to his or her attention, unless otherwise noted.)
Name: Click here to enter text.
Phone: Click here to enter text.
Title: Click here to enter text.
E-mail: Click here to enter text.
PROPOSAL NARRATIVE
Please provide a complete response to each of the prompts listed below. Your complete narrative should be
approximately 1-2 pages in length.
AUDIENCE. Who do you plan to serve? How many people do you expect to participate? What will you do, or have you
done, to build this audience?
Click here to enter text.
BIG IDEA. What is the “big idea” that you plan to explore? Why is it important to your community?
Click here to enter text.
FORMAT. How will you engage people in this discussion? What resource/s do you plan to use?
Click here to enter text.
SCHOLAR-FACILITATOR. Who will serve as the scholar-facilitator/s? Why are they a good fit for this project? What role,
if any, did they play in the planning process?
Click here to enter text.
WORK PLAN. Provide a detailed timeline that covers the planning, implementation, and evaluation of this project,
including discussion event dates. What are your target deadlines for critical activities and deliverables? Who is
responsible for each piece?
Click here to enter text.
PROPOSED BUDGET
Please provide a complete project budget below.
BUDGET ITEM1
METHOD OF
COMPUTATION2
COST SHARE4
NJCH
REQUEST3
TOTAL5
1. Salaries (Employees)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
2. Fees (Other Personnel)
3. Travel
4. Supplies
5. Services
6. Other
TOTAL:6
1
Itemize each anticipated expense.
Explain how you calculated the value of that expense (e.g., 10 hours @ $10/hour).
3
Allocate up to $500 in expenses as part of your grant request.
4
Allocate additional expenses to your share of the project cost (your total share must be at least equal to the value your
total grant request).
5
Total the values in each row.
6
Total the values in each column.
2
APPLICATION CHECKLIST
The required application forms must be submitted electronically to grants@njch.org. Applicants will
receive an electronic notice confirming receipt of their submissions within 24 hours.
Questions may be directed to NJCH’s grants officer, Robert Apgar, at 609-695-4838 or rapgar@njch.org.
Application Contents
☐
2015 Community Discussion Grants Program Application
• Cover sheet
• Proposal narrative
• Proposed budget
☐
CV or biographical sketch of scholar-facilitator/s
☐
Signed copy of Certification of Adherence to NJCH Grant Provisions
☐
Letter confirming nonprofit or government status
☐
(Optional) Letters of support from other project partners