EmailMe Form - Chapter Grant Application

Chapter Grant Application

To be eligible for a Chapter Grant your chapter must have made a donation to the MNWT Foundation within the past two (2) years. Application is due December 1. Grant requests are awarded in the range of $200.00 to $2,000.00 based on funds available.

Use the File Upload field found at the bottom to include the required attachments.

Responses to the online form will be viewed by the MNWT Foundation President by due date. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2015)

Applicant & Chapter Information
Your Email *
Applicant Type *
I am the Chapter President.
I am NOT the Chapter President.
Applicant Name *
First Last
Applicant Phone *
### - ### - ####
Applicant Address

Street Address City State / Province / Region Postal / Zip Code
District *
Chapter Name *
Chapter Membership
Chapter President Name *
Chapter President Phone *
### - ### - ####
If differs from applicant's phone
Grant Request Information
Amount Requested *
$ Dollars . Cents
Project Begining Date *
MM / DD / YYYY
Project Completion Date *
MM / DD / YYYY
Project Summary *
Summarize the project, briefly and concisely, using one or two paragraphs, and stating the main goal
Introduction *
Describe why your group is well suited to do this project
Statement of Need, Problem, or Concern *
Explaing the needs are to be met and why
Objectives / Goals *
Describe what the planned outcome of the program will be
Methods *
Describe how you plan to accomplish the goals and objectives including time schedule, resources
needed, and involvement of community and non-members
Publicity *
Describe how the project will be promoted, and how will recognition be given to the Minnesota Women of Today and your chapter
Evaluation *
Describe how you will determine to what degree your objectives/goals have been met
Future Plans *
Describe if this project is ongoing, and what the future plans are
Participation / Involvement Statistics *
Estimate the total number of people to be directly involved in completing this project, and the number of members and others
Equipment Request
I have an equipment request.
I do NOT have an equipment request.
Equipment Request Information
Equipment Type *
Describe and attach pictures, if possible; list each item and quantity to be purchased
Equipment Usage *
Explain how and where the equipment will be used
Equipment Benefit *
Explain who and how many will benefit from this equipment (indicate any type of disability)
Equipment Supplier(s) *
Name of at least two companies contacted, and lowest bid amount on this equipment; upload supporting papers, if possible
Equipment Supplier Discount *
Enter the company with the lowest bid that allows a "charity discount" and the amount; if the company allows a trade-in, enter the amount offered
Budget
Financial Information
I wish to enter my information into this form.
I will upload income and expense information related to the extension.
INCOME: Foundation Grant *
$ Dollars . Cents
Enter zero if these funds are not available to you
INCOME: Other Donation/Sources *
$ Dollars . Cents
Enter zero if these funds are not available to you
Description of Other Donation/Sources *
INCOME: Fundraisers Completed by
Chapter *
$ Dollars . Cents
Enter zero if these funds are not available to you
INCOME: Future Fundraisers planned by
Chapter *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Phone calls *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Postage *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Copies *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Room Rent *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Publicity *
$ Dollars . Cents
Enter zero if these funds are not available to you
EXPENSES: Other Expense(s) *
$ Dollars . Cents
Enter zero if these funds needed by you
Description of Other Expenses *
File Upload *

Add File

SUPPORTING MATERIAL: Upload any available letters supporting your grant request, any pictures,
brochures, etc., that will help tell your story. (Send 6 copies if possible.)

Applicant & Chapter Information

Grant Request Information

Equipment Request Information

Budget