KSA Mini-Grant Application Submit the following information in the order requested below as your grant application. Where word limits have been given, please do not go over those limits. * KSA member applicant name: * KSA member applicant contact information: Email (if applicable) Phone Mailing address: (If member applicant is an organization or family, please give the membership name and identify an individual contact person. If the member applicant is under 18, please give the name of the member and identify the parent or guardian who will sign the application form and grant agreement form if the funding is awarded.) * Project title: (what KSA should call this in publicity if your project is funded - no longer than 10 words please) * Description of your project (Maximum 600 words) Include what, when, where, how, and who will benefit. * Explain how your project supports the KSA Mission, including the specific KSA Goals supported (Maximum 400 words; KSA Goals may be listed by Goal number. See KSA Mission and Goals) * How will you publicize KSA support of this project? (Social media? Print media? Broadcast media? Announcement to an event audience? -- tell us your plan. ) (Maximum 300 words) * Please see the KSA credit requirements in the Grant Guidelines. Yes or no, will you meet those requirements? See KSA Grant Guidelines * Identify Your Project Partner: Name: Contact information (email if applicable, website if applicable), phone, mailing address, contact person if partner is not an individual * What are your project partner’s responsibilities in this project? (300 word maximum, if includes funding, please state that here.) * What are your responsibilities in this project? (300 word maximum, if includes funding, please state that here.) * Where will your matching money come from? List the source(s) and how much each will provide. If some of your match will be in-kind, be sure to include that. * Project Budget (Your project budget will not only help the Grant Review Committee see that you have the required funds, but it will also help the committee evaluate the feasibility of your project given your available funding and your anticipated expenses.) Project Income o Cash amount requested from KSA o Cash amount provided from grant funding source(s) o In-kind amount, if any. Total Project Income (Cash and value of in-kind services) Project Expenses (Including value of in-kind services) Please list all expenses. Total Project Expenses (Including value of in-kind services) * Supporting documents If your funding source(s) for the amount to be matched by KSA include(s) anyone other than you or your Project Partner, you must include a letter from your source(s) of funding. The letter should express their support for your project, including the specific amount and type (cash or in-kind) of funding they promise to provide. Your application must be signed and dated by you (parent/guardian if KSA member is under 18) and by your Project Partner. (In lieu of your Project Partner's signature on the application you may submit a letter from your Project Partner. For this letter they may copy and paste their responsibilities as described in this application; state they agree with them, and sign the letter.) How to Submit Your Application: Your application may be submitted by email to grants@kystory.org or by postal mail to KSA, P O Box 354, Frankfort, KY 40602. Applications must be received by the 1st of each month and 8 weeks before your project begins. Questions? Contact grants@kystory.org (End of KSA Mini-grant Application)