Matching Grant Application

Criteria:

Matching grants up to the sum of $1,000 will be considered for Lions Club projects funded directly by the Club from their fundraising activities. An eligible project includes capital expenditures (depreciable assets,) initial start-up costs and associated expenses for the purchase of equipment, real estate or improvements to real estate
Clubs must be current on dues to the District, State and LCI
Matching grants for charitable donations made by the club are not eligible
Matching grants for the direct benefit of one individual will not be considered
Matching grants for club operations and routine maintenance costs are not eligible
For the complete Foundation Matching Grant overview download the attached Foundation Matching Grant criterion.

Additional guidance is contained in a document available on the Foundation website or by contacting any Trustee.

We encourage organizations that receive a grant to assist the Indiana Lions Foundation Inc by one or more of the following:

Purchasing a W.P. Woods Fellowship
Selling tickets at the Indiana State Fair
Purchasing an Indiana Lions license plate
Purchasing a Brick Paver

"*" indicates required fields

Section I:

Name of Lions Club making the request*

District*

Project Title*

Amount requested (max of $1000)*

Contact Person*

First Last

Title*

Federal EIN*

Address*

Street Address City State ZIP Code

Phone*

Briefly Describe the Project*

Reason for the project*

(Present the problems or needs that are to be met and how the project will meet those problems or needs.)

Select file to attach for additional project information

Max. file size: 50 MB.

Section II

Proposed Budget (A project budget is mandatory)*

Break down the total budget into specific items that are detailed and as accurate as possible (equipment, salaries, rent, supplies, etc). A narrative description should precede the itemized budget, explaining budget figures that are not self-explanatory or that are unusual. Any significant donations or matching funds should also be noted. Would a Foundation Grant assist you in receiving other matching funds? Attach additional sheets if necessary.

Select file to attach for budget information

Max. file size: 50 MB.

Total Project Cost*

Has your organization or this project previously received a grant from the Indiana Lions Foundation?*

Yes

If yes, what year?

To the applicant:

In making this application, the Lion agrees to accept responsibility for the conduct of this project. The applicant also agrees to make a six (6) month report within (1) year of the receipt of the grant. The applicant also agrees to furnish a photo of the completed project and authorizes the picture's use for publicity purposes.

No further Grant requests for this Club will be considered until these conditions have been met.

Signature of Authorized Officer*

By typing my name above, I acknowledge that I have actual knowledge of the contents of this form and I understand the requirements and further agree that this is valid and can be used as my signature.

Date*

One of the criteria for an Indiana Lions Foundation Grant is that the Club is in good standing with the District and all financial obligations with the District, State, and Lions Clubs International are current.

I hereby acknowledge and verify that my District Governor is aware of this project and funds request and that the above conditions have been met.

Please list name of Current District Govener*