Buffalo County Community Partners Simple Grant Request Form
The Simple Grant Request Form is used by Buffalo County Community Partners for grant applications up to $1,000. Applicants must meet specific health goals and may require collaboration with one of the Community Partners Goal Work Groups. The form also necessitates discussions with the Community Partners office before submission.
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How do I fill this out?
To fill out this form, start by contacting the Buffalo County Community Partners office to discuss your project and timeline. Then, complete the required fields in the form with detailed information about your project. Finally, submit both an electronic and a physical copy of the completed form.
How to fill out the Buffalo County Community Partners Simple Grant Request Form?
1
Contact the Community Partners office to discuss your project and timeline.
2
Complete the required fields with information about your project.
3
Mark the goal area(s) that your project addresses.
4
Describe the project, its goals, and its collaboration details.
5
Submit the electronic and physical copies of the form.
Who needs the Buffalo County Community Partners Simple Grant Request Form?
1
Non-profit organizations seeking funding up to $1,000.
2
Organizations addressing health goals in Buffalo County.
3
Groups collaborating with Community Partners Goal Work Groups.
4
Entities needing support for health-focused projects.
5
Applicants who require a fiscal agent for their grant requests.
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What are the instructions for submitting this form?
Submit the electronic application to info@bcchp.org and mail a hard copy to PO Box 1466, Kearney, NE 68848. Contact Denise Zwiener at (308) 865-2280 to discuss your project. Ensure the submission is done 90 days prior to the proposed project date for thorough review. My advice is to follow up with the Community Partners office to confirm receipt and get feedback on the application before final deadlines.
What are the important dates for this form in 2024 and 2025?
For 2024 and 2025, grant applications are accepted on a monthly basis. Contact Denise Zwiener for application deadlines.
What is the purpose of this form?
The Simple Grant Request Form is intended to help non-profit organizations apply for grants up to $1,000 from Buffalo County Community Partners. It aims to support health-focused projects that align with the community's priority health goals. This form ensures that applicants provide all necessary details and engage in preliminary discussions with the Community Partners office before submission.
Tell me about this form and its components and fields line-by-line.
- 1. Name of Proposed Program / Project: The name of the program or project for which you are seeking funding.
- 2. Applicant Name: The name of the applicant or organization submitting the request.
- 3. Contact Name/Address: The contact details including name, address, phone, and email.
- 4. Grant Type: Specify whether the grant is a Match Grant or Educational Grant.
- 5. Sources of Match Funds: List the sources of match funds if applying for a Match Grant.
- 6. Goal Areas: Mark the goal areas that your project addresses from the specified list.
- 7. Environmental Strategies: Indicate which environmental strategies your project will address.
- 8. Project Description: Describe the project, including how it meets the community goals and how success will be measured.
- 9. Collaborating Organizations: List the organizations you will collaborate with for the project.
- 10. Support Requested: Describe the support being requested from Buffalo County Community Partners.
- 11. Project Timeline: Provide the timeline for the project and when support will be needed.
- 12. Budget: Include the total grant request, total in-kind/match funding, and total project budget.
- 13. Proof of 501 (c) 3 Status: Attach proof of your organization's 501 (c) 3 status or name your fiscal agent.
What happens if I fail to submit this form?
Failing to submit this form may result in the inability to secure funding for your project.
- Funding Denial: Your project will not receive the requested grant funds.
- Project Delays: Delaying the submission will postpone your project start date.
- Collaboration Impact: Potential collaborations with community partners may be affected.
How do I know when to use this form?
- 1. Grant Funding Request: Apply for financial support for your health-related project.
- 2. Project Planning: Outline your project details and collaboration plans.
- 3. Community Goals Alignment: Ensure your project aligns with community health goals.
- 4. Fiscal Agent Requirement: Identify a fiscal agent if your organization lacks 501 (c) 3 status.
- 5. Environmental Strategies: Address environmental strategies to promote health and safety.
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