GRANT AVAILABILITY for 2012. Grants of up to three thousand dollars ($3,000) are available. Deadline for receipt of applications is April 1, 2012. Awards will be announced by June 1, 2012.

ELIGIBLITY. Organizations must meet ONE of the following three criteria to be eligible to apply for grants from the Trust:
1) The organization is based in Acworth, NH –OR-
2) The organization includes Acworth among its members or constituents –OR-
3) The organization is a registered nonprofit in NH or is an IRS approved 501c3.

ORGANIZATION’S FINANCIAL SUMMARY. This statement should include a consolidated report for the last FY and the current FY operating budget. The Trust may ask for further financial specifics as it deems appropriate.

SELECTION CRITERIA.
Application form is properly completed by an eligible organization.
Proposal describes the project clearly.
Specific benefits to the town of Acworth and its citizens are demonstrated.
Proposed budget is clearly outlined.
Proposal includes a plan to share the project with the community.

SELECTION PROCESS. The goal of the process is to further the mission of the Trust and to be fair towards all applicants. Applications will be evaluated for compliance with the selection criteria. The selection process may include review by an independent panel. An interview may also be required. All applications will be carefully reviewed and each applicant will be notified of the final decision on their application.

GRANT RECIPIENTS’ RESPONSIBILITIES.
Present a midterm report of progress, written or in person.
Fulfill the plan to share the project with the community.
Submit a final report documenting completion of the grant project, including photographs, as appropriate, and invoicing of qualified expenses.

Recipients of grants agree, if asked, to include the statement "Made possible, in part, through a grant from the Acworth Community Charitable Trust" in any publicly released statements regarding the project. Recipients may be asked to participate in media events to further community awareness of the Trust’s activities.

SUBMISSION. Completed application, pages 3-5 of this package, and all supporting documentation must be received by the Trust by April 1, 2011. Please mail one copy to:

Acworth Community Charitable Trust
PO Box 10
Acworth, NH 03601

Also, all applications MUST be submitted electronically in either Word or pdf format to frogwood@myfairpoint.net 

APPLICATION FOR GRANTS TO ORGANIZATIONS

Date of Application:

Name of Organization:
Address:

CEO/President/Chair:
Phone: Email:

Contact Person:
Address:

Phone: Email:

NH Nonprofit Business ID # _____________501c3#_____________(if applicable)

Are any Directors of the Trust involved in your governance or in any business relationship with your organization? Yes___ No____ If yes, please explain.

Category of Application (check one). Conservation___ Historic Preservation_____
Special Purpose_____ Specify_____________________________________

Amount requested:___________________________

Summary of the proposal in 1-2 sentences___________________________________

________________________________________________________________________

Please attach a statement in two pages or less describing your proposal. List any partners in your project and the role they will play. Include a budget for your proposal and the costs the grant is to cover. Explain how your project will benefit the town of Acworth and its citizens and how these benefits will be shared with or communicated to the town at the completion of the project.

Attach any documentation to support your qualifications for the proposed project, repertory of your past accomplishments in the field, and other recommendations.

INCLUDE YOUR COMPLETED APPLICATION CHECKLIST

I hereby acknowledge that if any funds received by the organization are not used in accordance with the terms of the grant, the organization may be held liable for their repayment in full, including costs of collection.

Signed:

Printed:

Title:

Date:

FOR OFFICE USE ONLY

Date received:

Date presented to the Board of Directors:

Date and action taken:

Date contract received:

Date midterm report received:

Date final report received:

Date of Board approval of final report:

CHECKLIST FOR ORGANIZATIONAL GRANT APPLICATION

____Application form completed and signed

____Mission Statement and brief description of the organization

____List of current directors and officers

____Current financial report

____Description of proposal
____Leadership, partners and roles
____Project name and description
____Proposal budget and costs to be covered by grant
____Is this proposal part of a larger project? If so, please describe
____Your organization’s qualifications for conducting the project
____How the project will benefit Acworth and its citizens
____Plan for bringing your project back to the community

____ Supporting documents (Please list)