Grant proposal template

Grants Home

These fields are from the Minnesota Common Grant Application Form. Some of our smaller grant proposal will be Minnesota focused, so this is a place to start.

Proposal Information

Please give a 2-3 sentence summary of request:

Population served:Physicians and Healthcare facilities who are seeking a reduction in cost for full-cycle medical billing and collection.

Geographic area served: Anywhere in the US

Funds are being request for (check one):

____x General operating support

__X Project/program support

___x Start-up costs

____ Technical assistance

____x Capital

____ Other (list)

Project dates (if applicable): January 2010 through May 2010

Fiscal year end: JUNE 30, 2010

Budget -

Dollar amount requested: $ 20,000

Total annual organization budget: $

Total project budget (for support other than general operating): $

Proposal Narrative

I. Organization Information:

Leave empty for now ... will draft common base.

II. Purpose of Grant

1. Situation

a. The opportunity, challenges, issue or need and the community that your proposal addresses. The general public will be best served by undrstanding theat the common icons that they believe to be fresh and new are based in historic works of art. Understanding this concept the thirst to find the source f such Icons will lead to self discovery and individual reasearch in the arts.

b. How that focus was determined and who was involved in that decision-making process.

2. Activities

a. Overall goal(s) regarding the situation described above. The goasl of this research will be to show the correlatiohn between common 21st century icons with their Historic art countertparts, thereby opening the world of art to the general public.

b. Objectives or ways in which you will meet the goal(s).

c. Specific activities for which you are seeking funding.

d. Who will carry out those activities.

e. Time frame in which this will take place.

f. How the proposed activities will benefit the community in which they will occur, being as clear as you can about the impact you expect to have.this imapct will be crucial in understanding that art and the disource associated with it is a vital part of modern society and should never be eliminated from schools curriculum.

g. Long-term strategies (if applicable) for sustaining this effort.

III. EVALUATION

A. Please describe your criteria for success. What do you want to happen as a result of your activities?

B. How will you measure these changes?

C. Who will be involved in evaluating this work (staff, board, constituents, community, consultants)?

D. What will you do with your evaluation results?

Project Budget

Here is a project budget worksheet.

INCOME

Source Amount

Support

• Government grants $
• Foundations $
• Corporations $
• United Way or other federated campaigns $
• Individual contributions $
• Fundraising events and products $
• Membership income $
• In-kind support $
• Investment income $

Revenue

• Government Contracts $
• Earned Income $
• Other (specify) $
• $

Total Income $

EXPENSES

Item Amount $FT/PT

• Salaries and wages (breakdown by individual position and indicate full- or part-time.)
  • $
  • $
  • $
  • $
  • $
  • SUBTOTAL: $

• Insurance, benefits and other related taxes $
• Consultants and professional fees $
• Travel $
• Equipment $
• Supplies $
• Printing and copying $
• Telephone and fax $
• Postage and delivery $
• Rent and utilities $
• In-kind expenses $
• Depreciation $
• Other (specify) $
• $
• Total Expense $

DIFFERENCE (Income less Expense) $