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:

* 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.)

* How will you publicize KSA support of this project? (Maximum 300 words)

* 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? (200 word maximum)

* What are your responsibilities in this project? (200 word maximum)

* If your funding source is not your project partner, identify the source(s) of your funds by providing names, contact information, and the specific funding each will provide.

* 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
o In-kind amount, if any, provided from grant funding source
o Amounts and sources of additional income (such as ticket sales, registration fees, donations, and merchandise sales)
Total Project Income (Cash and value of in-kind services)

Project Expenses (Including value of in-kind services)
Please list all expenses and identify which expenses will be paid for by the KSA grant.
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 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 which states their agreement with their role in the project.)  



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 4148, Frankfort, KY 40604-4148.  Postal mail must be postmarked by October 15; email must be submitted by midnight local time (Eastern or Central time zones only) on October 15.

Questions?  Contact grants@kystory.org 

(End of KSA Mini-grant Application)