Bucyrus Area Community Foundation
Grant Application

Click here to download a copy of the BACF Grant Application in Word.

If you choose to use the Word document as your application, please submit the completed application to janet@bacfoundation.org

Complete and submit the form below to apply for a grant from the Bucyrus Area Community Foundation. Please complete all the areas that pertain to your organization and this grant.

Depending upon your particular grant request, some sections of the non-profit grant application will not apply. Providing more information will help the Bucyrus Area Community Foundation understand your request, this making the non-profit grant application process easier.

Please contact the Bucyrus Area Community Foundation with questions or concerns.

Bucyrus and Crawford County Ohio Grant Application

Important Information

**Areas that require lengthy answers may be typed into Word and copy & pasted into the box

**The following information is also needed and should be sent via email to janet@bacfoundation.org
- Copy of the IRS determination letter
- List of current board members
- Financial statement: yearly financial report & audit if available

Organization Information

Applicant Organization *

Doing Business As:

Previous Name (if changed)

IRS Letter Date

Tax Exempt ID#

Executive Director Name

If Applicable

Attorney Name

Accountant Name

Contract Fundraiser

Fiscal Sponsor

Contact Information

Proposal Contact Name

Title

Phone

Fax

Email (kept private) *

Organization Website

Street Address

Street Address

City

State

Zip

Mailing Address (if different than above)

Mailing Address

City-Mailing Address

State-Mailing Address

Zip-Mailing Address

Organization Financial Information

Fiscal End-of-Year Date (MM-DD-YR)

Organization's Budgeted Expenses for Current Year

Endowment Size

Organization's Major Funding Sources by Percentage

Organization's Affiliation

Are you affiliated with United Way?

Chapter of National or Regional Organization

Grant Request Information

Amount of this request? *

Total amount of project? *

Anticipated Project Start Date (MM-DD-YR)

Total # of People to be Served during Grant Period

Communities/Counties Served by this Program/Project

Brief demographic description of population served by this Program/Project

Type of Request

Other type of request information

Organizational Information

Brief Summary of Organization’s History and Statement of Mission:

Population and Geographic Region (Community/County) Served by This Organization

Project

Description of Overall Program/Project to Be Funded under This Grant

Who Will Be Served, Target Audience, How Many Will Be Served, Etc

This program is:

Program Start Date (if applicable)

Program End Date (if applicable)

Target Age (if applicable)

Target Geographic Area (if applicable)

Project Outcomes

Specific Outcomes You Anticipate as a Result of Your Methods:

Methods You Will Use:

Tools and Indicators/Data to Measure the Success of This Project:

Other Agencies/Organizations Actively Collaborating, and Their Role:

How This Grant Will Benefit Our Community:

What Will Assure Sustainability of the Project:

Program/Project Funding

Other Funding You’ve Received and/or Is Committed to This Project:

Will You Accept Partial Funding?

If So, How Will You Scale Back and Still Attain Your Goal:

Financial Report

(may be submitted on attached sheet if previously prepared):

Expenses

Salaries

Payroll Taxes

Fringe Benefits

Consultants & Professional Fees

Travel & Transportation

Equipment

Supplies

Printing & Copying

Telephone & Fax

Postage

Rent

Utilities

Maintenance

Evaluation

Marketing & Advertising

Other Expenses

Total Expenses

Revenue

Please indicate any additional funding that is committed for this project: the amount and organization making the commitment.

I agree with the following statement: Typing my name in the box below constitutes my signature. If this signature is not a CEO, Board President, Executive Director, or Superintendent’s signature, an email from the CEO, Board President, Executive Director, or Superintendent must be sent to the BACF stating their knowledge and consent for this application.

I Agree *

Yes

Name *

You must press "Submit" to complete your application submission.

Bucyrus Area Community FoundationGrant Application