Dickinson County Endowment Fund
2006 Grant Application
A Proposal for Dickinson County Endowment Fund
Grant Dollars for a Middle School Youth Leadership Program
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Dickinson County Endowment Fund
Cover Sheet
Date of application:
8/24/2006
Application submitted to:
Dickinson County Endowment Fund
Organization Information
Name of organization
Legal name (as listed with IRS)
ISU Extension – Dickinson County
Organization Address
City, State, Zip
Employer Identification Number (EIN)
1600 15 Street
Spirit Lake, IA 51360
XXXXXXXXXX
Phone
Fax
Web site
712-336-3488
712-336-3498
www.extension.iastate.edu/dickinson
Name of contact person regarding
this application
Phone
E-mail
Karen Byers
712-336-3488
ksbyers@iastate.edu
Type of funding sought (circle one):
EDUCATIONAL
Charitable
Civic
Public
Patriotic
Religious
YOUTH SERVICES
Natural Resources
Recreation
Family Services
ECONOMIC
DEVELOPMENT
Housing
Transportation
Conservation
th
Project focus area
(circle all that apply)
Is your organization an IRS 501(c)(3) not-for-profit?
x
Yes
If no, is your organization a 170b unit of government?
Yes
If no, you must have a fiscal agent. Please list name, address, phone and fiscal agent contact
person:
Iowa 4-H Foundation
No
No
XXXXXXXXXX
Fiscal agent’s EIN number
What is your fiscal calendar? (Mo/Yr) to (Mo/Yr)
July 2006 to June 2007
Describe your organization’s charitable purpose, program activities, and population served.
(4-5 sentences) The mission of Iowa State University Extension (ISUE) is to build partnerships and
provide research-based learning opportunities to improve quality of life in Iowa. More specific to
the 4-H & Youth Development program area, the mission is to empower youth to reach their full
potential working and learning in partnership with caring adults. In Dickinson County, youth
seventeen years of age or younger represent approximately 3600 people or 22% of the population.
List any major changes that have taken place in your organization in the last two years. ISUE
has been a part of serving youth for over 100 years through the world’s largest youth organization
-- 4-H Clubs. Over the past several years more intentional outreach has occurred to provide
leadership, teambuilding, and youth adult-partnerships in after school programs, school enrichment
activities, and numerous special interest initiatives. In Dickinson County Extension we have
partnered with other community organizations to create and deliver 3 annual retreats to bring
nearly 100 high school student council members together each year from throughout the county.
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Dickinson County Endowment Fund
The success of this high school leadership initiative has also brought about interest from school
districts to implement similar program opportunities at a middle school level.
Briefly describe your organization’s history (year organized) and major accomplishments.
What evidence can you provide that you will be able to carry out your project? Iowa has the
honor of being the birthplace of the 4-H & Youth Program in 1902. By 1916 Dickinson County was
providing this opportunity for youth. Today, this programming is not only offered in every county in
the state, but has grown nationally and internationally to become the world’s largest youth
organization. Ties with Iowa State University ensure that youth program initiatives are founded
with research-based methods. In addition, Extension & 4-H Programs in Dickinson County have a
rich history of partnerships with other community organizations, business entities, and non-profit
groups. Projects have had a successful history because of state and local level partnerships.
Examples of these partnership successes include: 3 years of Lakes Area Student Council Annual
Retreats (LASCAR) and 1 pilot “Ricochet: An Extreme Middle School Leadership Adventure” in the
Harris-Lake Park School District. Both of these leadership initiatives have been supported by local
Kiwanis groups, Priority #1, banks, restaurants, and other businesses. Additionally, ISUE has
secured approximately $4500 in grants from America’s Promise, Alcohol & Drug Treatment Unit,
and the Iowa Department of Public Health to support these two leadership initiatives. The high
school LASCAR concept is award-winning, receiving a $1000 National Great Idea Award from
America’s Promise and an Iowa Association of Extension Council’s Outstanding Program of the Year
Award. We believe our proposed middle school leadership initiative will be equally successful.
Application
Request Summary
Describe the proposed project, including the goals and objectives. Discuss the community need for
the project, what populations it will serve, the benefits for the community as a result of the project
and the community support for the project.
 The project proposal we have is for support for the expansion of the “Ricochet: An Extreme
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Leadership Adventure” pilot program with middle school students in Dickinson County.
“Ricochet” is designed to help youth discover their leadership abilities and look toward the
possibilities they have to impact their communities and county.
The 15-hour program combines discussions and hands-on challenge-type activities for youth to get a
better understanding of leadership in their communities, as well as a community leadership service
project selected and implemented by the youth participants.
The first pilot program was conducted with 12 Harris-Lake Park middle school student council
members during the ’05-’06 school year.
The success of this leadership program was shared with the Spirit Lake Middle School Principal, Mr.
Ratzlaff, and he would support this being offered to the entire middle school student body or
approximately 400 students! Realistically, we propose to start with 6th graders and eventually add 7th
and 8th graders as the program evolves beyond a pilot phase. Our initial pilot with Spirit Lake would
be with approximately 100 middle school students.
Ricochet provides opportunities for adult, youth and community partnerships through volunteerism
and financial support. Volunteer adults and high school students assist with program delivery,
leadership discussion panels, refreshments and more. Financial support is needed to purchase
program supplies, participant t-shirts, training equipment, staff time and travel for training trainers
and conducting the program, rental fees for facilities, possible transportation costs, marketing, etc.
Extension proposes a train-the-trainer format to train community leaders and high school students to
help deliver the program with middle school students during the ’06-’07 school year.
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Dickinson County Endowment Fund

The ultimate outcome of the program is for youth to see themselves as leaders in their communities.
We plan to expose them to community leaders and opportunities and encourage them to see
opportunities they have which in turn would provide economic development in Dickinson County.
Population served 100 youth +
(estimated #): 20 trainers
Total project cost: $5600.00
Are matching funds YES
being used?
Grant monies needed: October 2006 to May 2007
(Mo/Yr) to (Mo/Yr)
Total requested from the DCEF $1350.00
In-kind contributions? $1430.00
What percentage of total funds
raised are matched dollars?
100%
Outline other resources or partners identified to assist with the project; the nature of the in-kind
contributions if any, and any other funding secured, applied for and proposed for the project:
 We currently have $1500 in grants from the Iowa Department of Public Health and a partnership
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with Priority #1 of Dickinson County to help implement Ricochet programming in Spirit Lake.
We are asking for $2500 from the Dickinson County 4-H Foundation.
We will be seeking financial and in-kind support from local businesses, organizations, and others
based on the amount of funding secured prior to the asking.
ISUE will provide staff, as well as, in-kind donations with curriculum development, challenge training
equipment, printing, marketing, phone calls, some travel expenses, and such.
As with the Harris-Lake Park pilot program, we also plan to seek in-kind donations for facility use and
refreshments for the students. If these are not donated, they will add to our budget expenses and
asking from community partners.
Indicate desired impact and how you will measure and evaluate the results of the project. Be
specific regarding community needs/issues your project will address.
Youth completing the Ricochet Adventure will be able to:
 identify characteristics of leaders
 identify themselves as a leaders
 share ideas more easily with others
 recognize what causes communication breakdowns
 explain the connection between values and decisions
 use a decision-making model to make a group decision
 use positive techniques for managing the stress associated with leadership
 identify a leadership service project in their community; develop an action plan for the project; and
complete the project in their community
Ricochet is intended to be a three-phase leadership development program. It is based on the 3 stages of
adolescent leadership development identified by the researchers, VanLinden and Fertman in “Youth
Leadership: A Guide to Understanding Leadership Development in Adolescents”. Ricochet is an experiential
program during which youth improve their leadership skills by reflecting on their experiences, sharing their
ideas, listening to others, making good decisions, and managing their stress. Participants will interact with
adult community leaders and high school students to learn from them. Youth in the program will also be
deciding upon and conducting a community leadership service project. (Please see attached photos for
examples of what these youth may be doing during the Ricochet Adventure!)
Our future goal is to involve all Spirit Lake 6th, 7th and 8th grade students in the three Ricochet program
phases to help prepare rural Iowa youth to become leaders in their communities both today and tomorrow.
After completing the program youth will be able to accept leadership roles in the community, for instance
serving on a local library board, a mayor’s task force, city recreation board or school advisory committee.
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Dickinson County Endowment Fund
What is the timeline for this project?
We plan to pilot the Ricochet program with Spirit Lake Middle School this fall and conclude with phase I of
Ricochet by spring of ’07.
Is this a project that will be sustained? If so, how will you sustain it?
We plan to sustain the program for a number of years. The ISUE Team that created this Ricochet Adventure
is developing a Ricochet II and III for middle school students. Pilots of these phases will be on-going during
the year. Future plans would be to see this pilot group of 6th graders continue next year with Ricochet II and
the following year with Ricochet III. We plan to build the program’s long-term sustainability by offering
phase I to all 6th graders, phase II to all 7th graders and phase III to all 8th graders in following years and
training more trainers to help with the facilitation. Ultimately, we hope that community leaders see the value
in this training and help support it for years to come! Additionally, we will continue to seek out grant funding
at all levels.
Attachments
In order to be considered for funding, your application MUST include the following items:
Copy of latest Federal IRS Tax-exempt status letter
List of Board of Directors, Director, Staff
Copy of most recent CPA audit, financial statement or tax return (IRS 990 form)
Signed ‘Letter of Intent’ to act as a fiscal agent – only if you are not 501(c)3 or 170b status
Signed Applicant Board Approval Agreement (see below)
Board Approval from Applicant Organization:
We approve submission of this grant request and certify that the purpose of this request is charitable
and that monies received from the Dickinson County Endowment Fund will be used solely for the
project stated in this application.
Board Chairman
Date
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For DCEFund use only:
Board of Directors
Determination:
Approved
Denied
Date
This application has been approved in the amount of $ _____________.
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Dickinson County Endowment Fund
Organization Budget
See Attached
Organizational
Budget
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Dickinson County Endowment Fund
Project Budget
INCOME
Source
Support
Government grants (IDPH Grant)
Foundations
Corporations
United Way or other federated campaigns
Individual contributions
Fundraising (Meals - $360 and T-shirts - $960)
Membership income
In-kind support (County Staff Time - $1430)
Investment income
Revenue
Government contracts
Earned income
Other (specify)
Total Income
EXPENSES
Item
Salaries and wages (indicate number of staff and
full- or part-time.)
1 - Area Youth Field Specialist
SUBTOTAL
Insurance, benefits and other related taxes
Consultants and professional fees
Travel
Equipment
Supplies (Folders, Pencils, T-shirts, and name
tags, etc…)
Printing and copying (Train-the-trainer Binders $440 and supplies; Registration Materials,
Brochures, Posters, and Student Packets $600)
Telephone and fax
Postage and delivery (2 mailings @.50 x120)
Rent and utilities (Trainer site & youth site)
In-kind expenses
Depreciation
Other (specify) (Leadership Service Project
supplies - $500; Refreshments for trainers &
youth for 3 sessions x $3/person = $360; )
Total Expense
Difference (Total Income less Total Expense)
Amount
$1500.00
$
$
$
$
$1320.00
$
$1430.00
$
$
$
$
$
$4,250.00
Amount
$
$1440.00
$
$
$1440.00
$
$
$ 400.00
$
$ 1200.00
%FT/PT
75% time
$ 1040.00
$
$ 120.00
$ 540.00
$
$
$ 860.00
$
$5600.00
$1350.00
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Dickinson County Endowment Fund
Attachments
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