Community Grant Application 2018


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NORTHWEST LOUISIANA MASTER GARDENER ASSOCIATION, INC.
(NWLAMG) COMMUNITY DONATION AND GRANT APPLICATION
 
Application Deadline
 
Email electronic application to nwlamggrants@gmail.com on or before September 30, 2018.
 
Answer all applicable questions included on this application.  If all applicable questions are not answered, the application will be deemed incomplete.  Maintain the format provided when answering the numbered questions.
 
Organization Information
 
Organization Name:  __________________________________________________________
 
Contact Person:  ______________________________________________________________
 
Mailing Address:  ____________________________________________________________
 
City/Town:  ________________________   Zip Code: _________   Parish:  ______________ 
 
Telephone Number(s):  ________________________________________________________
 
Email Address: ________________________________   Fax (optional):  ________________
 
Amount Of Money Requested: $__________________
 
NOTE: For accounting purposes, please clarify to whom the check should be written and provide that information below.
Name of organization or entity to be placed on the check:
 
 
 

 
 
Application Check List:
Please make sure you have included the following items before emailing your completed application:
 

_____ Completed application form in Word or PDF format
_____ Project budget
_____ Photographs and graphics (if available) of the site/project
_____ 501(c)(3) documentation if a non-profit organization
 
– FOR INFORMATION AND FOR ASSISTANCE IN COMPLETING THIS APPLICATION, CONTACT THE NWLAMG COMMUNITY INVESTMENT COMMITTEE VIA PHONE (318-564-1180 or 318-465-0000) OR EMAIL (nwlamggrants@gmail.com) OR VISIT OUR WEBSITE AT www.nwlamg.weebly.com –
 
– NEED HELP?  Contact Judy Roemer at 318-465-0000 or roemerj@bellsouth.net! –
 
COMMUNITY DONATION AND GRANT APPLICATION
 
Please answer the following questions.  Maintain the format provided below and number your responses accordingly. 
 
General Information
  1. What is the name of your project?
  2. What is the project location (address, city/town, parish)?
  3. Who is the Project Director and how may we contact him/her?
  4. Do you own or have permission to use the land where this project is proposed?
  5. Provide a picture(s) and graphics (if available) of the site and/or project.
  6. If your project includes plant installation, list the plant names, approximate number of plants, an estimate of square footage of the planted area and the general planting design.
 
Project Description
  1. Please describe your project and project objectives in detail including community involvement, estimated time line to completion, population to be served and handicap accessibility.
  2. Please provide a detailed overall project budget on a separate sheet of paper and indicate what portion of that budget will be funded internally from existing funds, by other/outside sources, and by the grant for which you are applying. Include any in-kind donations that you expect. 
  3. Are you collaborating with other organizations on this proposed project? If so, describe.
  4. Describe the volunteer component of your project both in the near and long term.
 
Information Regarding The Organization/Entity Utilizing The Requested Donation Or Grant
  1. Describe the purpose or mission of the group that will utilize the requested donation or grant.
  2. Is that organization a 501(c)(3) tax-exempt organization? If so, provide documentation.
 
Sustainability
  1. Describe plans for long-term maintenance of the project including details of who will be responsible for upkeep.
  2. Describe how funds for long-term maintenance will be provided.
 
Master Gardener Involvement
  1. Have NWLA Master Gardeners been involved in the planning or implementation of this project? If so, who and how?
 
 
 
– Need help?  Contact Judy Roemer at 318-465-0000 or roemerj@bellsouth.net! –
 
DONATION AND GRANT APPLICATION AGREEMENT BETWEEN
NORTHWEST LOUISIANA MASTER GARDENER ASSOCIATION, INC.
AND
 
__________________________________________________
 
An applicant who is selected as a recipient of a Donation or Grant will receive funds to be used to implement the proposed project. Recipients must agree to the following:

  • Recipients agree and commit to accept funds for the use stated in the application and to report on their expenditures in an honest, complete, and timely manner consistent with NWLAMG funding guidelines.
  • Recipients shall submit a final written report and financial accounting, with receipts attached, to the NWLAMG Community Investment Committee within thirty days of project completion consistent with NWLAMG guidelines.
  • Recipients may be asked to give a presentation to the NWLAMG.
  • Recipients understand the project must be completed within 12 months of receipt of funds and agree that (1) all monies awarded must be spent as outlined in the application and budget, (2) any changes in how money is to be spent must be approved in advance by the NWLAMG Community Investment Committee, and (3) any monies remaining at the end of the donation or grant period must be returned to the NWLAMG.
  • Recipients agree that the NWLAMG may use the proposed project information to publicize the award.
  • Recipients shall credit the NWLAMG during project installation and in printed materials and public announcements related to the project along with other donors as appropriate.
  • Recipients agree to cooperate in the NWLAMG evaluation and monitoring process to assure funded projects are implemented as proposed and to measure the effectiveness and sustainability of funded projects.
  • Recipients agree to hold harmless the NWLAMG for any and all claims or liability arising from implementation of the proposed project.
 
Representatives from our organization have read the requirements above; and, if selected as a recipient of a NWLAMG Community Donation or Grant, we agree to follow the requirements.
 
____________________________________                        ____________________________________
Signature of Contact Person for Application                    Signature of Supervisor or Financial Manager
 
_______________________________________                  ______________________________________
Print Name of Contact Person                                       Print Name of Supervisor or Financial Manager
 
 
Email to nwlamggrants@gmail.com on or before October 31, 2017.