Fill and Sign the Massage Therapy Minor Consent Form

Seeley Lake Community Foundation Small Grant Program Application Instructions 1. Fill in all requested information on the application and budget form. 2. The one to two page narrative should include: • A description of the proposed program or project, including a statement of the goals and objectives. • A description of the strategies you will use and tasks you will perform to accomplish the project/program goals, as well as the community needs that will be addressed and the specific results to be accomplished by the proposed program or project. • A description of how you will measure the success of your project or program. • Identify the key individuals and organizations involved in your project and their primary responsibilities. • A paragraph summarizing the project budget in terms of projected sources of income and expenses and identify the portion of the budget, in terms of tasks and outcomes, to be covered by the SLCF request (also completely fill in the budget form). 3. Additional required attachments: • A copy of your most recent IRS tax-exempt certification. If the applicant does not have taxexempt status or is not a government agency, a letter from a tax-exempt sponsoring organization should be attached that states the willingness of the sponsoring organization to received the grant funds on behalf of the applicant and administer the project through their organization. • A paragraph outlining your organizations mission statement, if it is not included in the narrative, and a list of board of directors with names, addresses and phone numbers. 4. Mail the original application and 3 copies of the entire grant application to the Seeley Lake Community Foundation, P.O. Box 25, Seeley Lake, MT 59868, on or before the posted deadline. The application and required attachments may also be emailed to – email@seeleylakecommunityfoundation.org. • “Entire grant application” refers to the 4 page grant application (includes information cover sheet, 2 page narrative, and budget page) and required attachments. • Don’ t forget to keep a copy for your records • Do not send cover letters, promotional material, bound applications, or other supporting documents not specifically requested. SEELEY LAKE COMMUNITY FOUNDATION SMALL GRANT PROGRAM APPLICATION ORGANIZATION INFORMATION: Name of Organization: Address: City: State: Zip code: Website Address: PRIMARY CONTACT/AUTHORIZING INDIVIDUAL: Name: Job Title: Phone: email: PLEASE CHECK ONE OF THE FOLLOWING: 501(c)3 organization Exempt government unit (please specify) Other (please specify other type and fill out qualifying sponsor information below): Type: Sponsor organization: AMOUNT REQUESTED: TOTAL PROJECT COST: Will these dollars be used to leverage/match additional funding? Yes No If yes, indicate how many additional dollars may be available and identify the potential source of the funds. Summarize how the grant dollars will be used to serve the community of Seeley Lake, Montana: PROJECT NARRATIVE: Provide a one to two page project narrative that includes: 1. A description of the proposed program or project, including a statement of the goals and objectives. 2. A description of the strategies you will use and tasks you will perform to accomplish the project/program goals, as well as the community needs that will be addressed and the specific results to be accomplished by the proposed program or project. 3. A description of how you will measure the success of your project or program. 4. Identify the key individuals and organizations involved in your project and their primary responsibilities. 5. A paragraph summarizing the project budget in terms of projected sources of income and expenses and identify the portion of the budget, in terms of tasks and outcomes, to be covered by the SLCF request (also complete the budget form). PROJECT NARRATIVE - Continued Seeley Lake Community Foundation Small Grant Program Budget Information Project Name: to Project Period: Budget Item Proposed Budget Amount Salaries (include benefits): 1. 2. 3. Subtotal Equipment/Supplies: 1. 2. 3. Subtotal Overhead/Operating/Administrative Expenses: 1. 2. 3. Subtotal Other: 1. 2. Subtotal TOTAL