Sturgis Area Community Foundation -
Healthy Youth & Healthy Seniors Fund Grant Application Form

INSTRUCTIONS - READ CAREFULLY:
Complete the following form in its entirety. After filling in the form, click the button to create your printable pages.
A cover letter should be included with each application, which introduces your organization and your grant proposal and makes a connection between your proposal and the purpose of the fund.  Please keep this cover letter to one typed page in length.

  1. Please submit 11 copies of your grant proposal.
  2. Include a copy of the current IRS determination letter indicating 501 ( c ) 3 tax-exempt status. **
  3. Include a list of your Board of Directors and affiliations.
  4. Include a copy of your organization’s current annual operating budget, including expenses and revenue.
  5. Include a copy of your most recent annual financial statement (independently audited, if available; if not available, attach your Form 990.  **
  6. Include the attached Grant Budget Sheet.
  7. Include the attached Grant Application Cover Sheet and attachment B.
  8. You may include letters of support for your project from other organizations.
  9. Include your annual report, if available.
  10. Grant money must be paid out within one year of approval.
  11. Each grantee receiving over $1,000.00 shall provide a written report to the Foundation of the outcome of the program for which the grant was given including the number of participants or people affected (if applicable).
  12. Programs must be for youth under age 18 and for seniors over age 65.
  13. Please call our office if you have any questions.

** If you have submitted your annual financial report to the Foundation within the last year, or your 501C 3 letter is in our file, you do not have to submit another with this application. 
 
GRANT APPLICATIONS are due October 15th annually or on an alternative date set by SACF

Please return your completed application to:
* Sturgis Area Community Foundation - 310 N. Franks Avenue - Sturgis, MI 49091



The Sturgis Area Community Foundation
Healthy Youth & Healthy Seniors Fund GRANT APPLICATION COVER SHEET

Date of Application:
Legal name of school or organization applying:
(should be same as on IRS determination letter and as supplied on IRS form 990)
Year founded: Current Operating Budget:
Executive Director: Phone Number:
Contact person/title/phone number:
(if different than Executive Director)
Address (principal/administrative office):
City/State/Zip:
Fax Number:
Email Address:


List any previous support from
this funder in the last 5 years:

Project Name:
Purpose of Grant: (1 sentence)
Date of Project: Amount Requested:
Total Project Cost:
Geographic Area Served:

BELOW IS A LISTING OF STANDARD BUDGET ITEMS. PLEASE PROVIDE THE PROJECT BUDGET IN THIS FORMAT

A. Organizational fiscal year:
B. Time period this budget covers:

EXPENSES
Amount requested from
The Sturgis Fdn
Total project expense
Salaries
Payroll taxes
Fringe Benefits
Consultants and
Professional fees
Insurance
Travel
Equipment
Supplies
Printing/copying
Telephone/fax
Postage & Delivery
Rent
Utitlities
Maintenance
Evaluation
Marketing
Other (specify)
TOTAL AMT REQUESTED:  
TOTAL EXPENSES:  
     
REVENUE
Committed Pending
Local Govt. Grants
State Govt. Grants
Fed. Govt. Grants
Foundation Grants
Corporate Donations
Individual Donations
Income from events
Income from products
Membership income
In-kind support
Other (specify)
TOTAL REVENUE: