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2015 Keokuk Area Community Foundation Grant Application
Section 1: Basic Information
 Deadline for all Grant Applications is August 31, 2015.
 Please refer to and read the 2015 Charitable Interests and 2015 Grant Guidelines before
starting this application.
 Please complete this application (with additional sheets as appropriate attached). This
application will serve as the cover page for the proposal.
 Please include a copy of your 501(c) (3) Tax Determination Letter (Please include only
one IRS Determination letter).
Section 2: Contact Information
*The undersigned submits the following information to the Keokuk Area Community
Foundation (KACF) for the purpose of requesting a determination by the Foundation as to
whether funds will be made available to the undersigned in the form of a grant. All information
will be kept confidential.
Name of organization seeking a grant from KACF:
The amount requested from KACF: $
(Please be specific and accurate in the proposed funding from KACF)
Contact person for your organization:
Mailing Address:
Phone:
Email:
Organization Website/Social Media Handle:
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Section 3: Project Scope
*Please attach a summary (of 2 pages or less) describing the scope of the project for which
funding is being sought including the project’s timetable and schedule. This summary will
include as much detail as possible (within the scope of two pages or less) to assist our Grant
Selection Committee in making their decision.
*Questions to Consider in Completing Section 3
 What are the specific community needs or problems that you are trying to solve
through the proposed project? Provide sufficient background and details to explain
why your proposed project is important to the local community.
 What is your proposed project? Explain its objectives and how it will help to solve the
problems you describe above. Describe how the project fits into your organization’s
long-range strategy and mission, and what the role of the board is in developing the
project.
 What steps will be involved in completing your project? Construct a timeline, if
relevant, and identify staff, volunteers, and board members who will be responsible for
key steps.
 How will you evaluate your project? List what questions you will ask to determine
whether your project was successful. Identify the individuals who will be responsible for
completing the evaluation and reporting to the community foundation.
Section 4: Funding Request/ Budget
*Additional Funding: Please also note for us if you are seeking funding for this project from
other Foundations and if this is a duplicate proposal for funding: (we may ask you to return a
grant we fund if you have also received funding for this project from any other Foundation, thus
duplicating our grant).
Yes, we are seeking funding for this project from other Foundations:
They are:
(Please use additional sheets as necessary to provide complete information)
No, we are seeking funding from KACF only!
Total Project Budget Amount: $
* On a separate sheet (and attach to this form) a detailed projected budget and indicate what
portion of it is funded, or is expected to be funded, by other sources.
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* In creating your projected budget, please include the following information: (Use the
information below as a guide and present your information in a format that is normal for your
organization while conveying the information below)
 Expenses and costs for purchase of materials and services.
 Other relevant expenses (if appropriate).
 Total number of donors that have provided funding to the project.
 Please include the amount of any previously received gifts, donations or contributions for
the project.
Section 5: Submitting the 2015 KACF Grant Application
* Please include 7 copies of this application for submission. Please include all sections of the
application. FAILURE TO MAIL THE PROPER NUMBER OF DOCUMENTS WILL
DISQUALIFY YOUR APPLICATION!
* If your organization received a grant in a previous year from The Keokuk Area Community
Foundation , please include a 2014 KACF Grant Report.
* Please indicate the year of receiving a previous Grant from KACF and the amount
received.
Year:
Amount: $
*PLEASE MAIL 7 (SEVEN) COPIES OF THE KACF APPLIACTIONALONG
WITH 7 (SEVEN) COPIES OF ALL ACCOMPANYING DOCUMENTS TO:
The Keokuk Area Community Foundation
PO Box 367
Keokuk, Iowa 52632
* Please do not forget to keep a copy of all documents for your files!
Section 6: Authorization
Name:
(Please print legibly)
Signature:
(The signature must be from the CEO or Executive Director of your organization!)