Donor Advised Fund Grant Application Please check our website for current due dates A separate application must be filled out for each fund you are applying to.

MACI Youth Fund - The primary purpose of this fund is to support youth education opportunities designed to benefit groups, not individuals. Youth Enrichment Opportunities designed to challenge, build, grow, and otherwise continue to stimulate and improve participants after the initial program is complete. Additionally, the fund may support various cultural, educational, recreational or environmental programs. (grant range $250 - $2,000)

Team One Plastics Corporate Donor Advised Fund – This fund supports educational opportunities that benefit the citizens of the greater Albion area. (grant range $100 - $600)

The Andersons Charitable Fund – This fund supports general charitable activities in the greater Albion area. (grant range $100 - $1000)

Application Deadline: Complete applications and materials are due no later than 4:00 p.m. on the due date. See www.albionfoundation.org for current due dates. at the office of the Albion Community Foundation, 203 S. Superior Street, Albion, Michigan 49224. This is NOT a postmark deadline.

Please email the application to [email protected] and submit one hard copy with original signatures to our offices at 203 S. Superior Street, or via mail at PO Box 156, Albion, MI 49224.

Please note that each fund has a different grant amount range.

Eligibility  A 501 (c)(3) or other tax exempt organization must be the fiscal agent for the program  The program must benefit the greater Albion area

Restrictions Limitations include: Grant funds cannot support the following: • activities conducted outside the greater Albion area, unless serving individuals from the greater Albion area • existing deficits, licensing fees, fines, penalties, interest or litigation • fundraising or allocations to endowment or other restricted funds • funds which the applicant would re-grant to other organizations • cash prizes, contributions, donations

Albion Community Foundation •203 S. Superior St. • PO Box 156 • Albion, MI 49224 • 517/629-3349 [email protected] • www.albionfoundation.org Albion Community Foundation Donor Advised Funds Grant Application

Applicant Organization's Name: Project Director:

Mailing Address: City: Zip Code:

Organization Phone: Organization Fax: Contact Phone: Contact Email Address: ( ) - - ( ) - - ( ) - -

Target Population Age Code: Target Population Gender Code: Grant Request Program Code: Please Choose Please Choose Please Choose Total Project Cost: Fund Applying to: MACI Youth Fund Team One Plastics Corporate Fund The Andersons Charitable Fund PROJECT SUMMARY

We are requesting funds to support enter program or project name. The purpose of our project is to address the need for what need will the program address, in one paragraph or less. Project activities will take place from to at at enter location (name and address).

This project will serve enter number served here enter the type of audience receiving direct services, i.e. youth, adults, people, etc. from the greater Albion area. The main goal of the project to: Describe the project purpose in about one par agraph.

In order to accomplish this we will conduct the following activities: provide a list of main activities

Project Budget: Grant funds will be used in the following manner: (please include as much detail as possible.)

Signature of Applicant Title

Date

Authorizing Official Signature Title (ie. Executive Director, Board Chair, City Manager, Superintendent)