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Boone County Community Grant Program
Organization
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Organization Email
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Person Submitting Grant Form Email
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Project Director/Contact Person
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Address
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City
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State
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Zip Code
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Phone
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Organization Email
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Person Submitting Grant Form Email
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Proposed Use of Funds
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Project Start Date
Project End Date
Budget summary
Organization’s most recently completed year’s
Income
Expenses
Total Cost of Project
Total Support
Amount of Request
Narrative 500 words or less
Proposed Project / Budget
Expenses-Cost of Each Item
Cash
In-Kind
Total
Fees to Individual Contractors for Project/Program
Travel & Related Expenses
Publicity Expenses
Rental Fees
Administrative Salaries & Taxes
Materials
Other Costs (Explain)
Other Costs Description
Total Cost of Project/Program
Revenue
Cash
In-Kind
Total
Budgeted from Organization’s Operating Funds
Other Grants or Gifts (Anticipated & Received)
Earned Income from Project/Program
Total Cost of Project/Program
In-Kind Support
Cash and In-Kind Total Available
Grant Request
Total Cost of Project/Program
We certify that the information contained in this application is complete, true, and correct to the best of our knowledge. Further, we certify that if this grant is awarded, all funds received will be used solely for the described activities in the manner specified in this application. All print materials and publicity for the project should say: This project was funded, in part, through a grant from the Boone County Community Foundation.”
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600 South State Street
Belvidere, IL 61008
(p) 815-544-7231
(f) 815-544-7221
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